Catalytic subunit of human telomerase reverse transcriptase is an independent predictor of survival in patients undergoing curative resection of hepatic colorectal metastases: a multicenter analysis.
OBJECTIVE
To determine the role of the catalytic subunit of human telomerase reverse transcriptase (hTERT) in predicting survival after resection of hepatic colorectal metastases (CRM).


METHODS
Two hundred one patients who underwent curative resection of hepatic CRM between 1990 and 2000 were identified from a multicenter database. The CRM were analyzed for hTERT nucleolar expression by standard immunohistochemical techniques. hTERT expression and known clinicopathologic factors of survival were examined.


RESULTS
With a median follow-up of 80 months, 152 patients (75.6%) had died; the 5-year overall survival was 30.7%. On univariate analysis, number of metastases greater than two (P = .0005), extrahepatic disease (P = .0054), disease-free interval less than 12 months (P = .006), carcinoembryonic antigen level greater than 200 ng/mL (P = .0071), and positive hTERT nucleolar staining (P < .0001) were associated with decreased survival. On multivariate analysis, three factors independently predicted survival: number of metastases (relative risk [RR] = 1.74; P = .0011); disease-free interval (RR = 1.70; P = .0035); and positive hTERT nucleolar staining (RR = 2.03; P < .0001). Patients with none or one of these factors had a 5-year survival rate of 48%, whereas those with two or three of these factors had a 5-year survival of 15% (P < .0001).


CONCLUSIONS
hTERT nucleolar expression is associated with worse survival after resection of hepatic CRM. hTERT expression in conjunction with number of hepatic metastases and disease-free interval may permit more accurate prediction of survival after resection of hepatic CRM.
Dômont
Julien
J
Institut Gustave Roussy, Division of Cancer Médecine, 39 Rue Camille Desmoulins, 94805 Villejuif, France.
Pawlik
Timothy M
TM
Boige
Valérie
V
Rose
Mathieu
M
Weber
Jean-Christophe
JC
Hoff
Paulo M
PM
Brown
Thomas D
TD
Zorzi
Daria
D
Morat
Luc
L
Pignon
Jean-Pierre
JP
Rashid
Asif
A
Jaeck
Daniel
D
Sabatier
Laure
L
Elias
Dominique
D
Tursz
Thomas
T
Soria
Jean-Charles
JC
Vauthey
Jean-Nicolas
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020134:Catalytic Domain; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology*; D004268:DNA-Binding Proteins; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000235:genetics* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis / Q000235:genetics*; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D019098:Telomerase / Q000235:genetics*
D004268:DNA-Binding Proteins; D019098:Telomerase