title: Prognostic significance of epidermal growth factor receptor expression in colon cancer patients undergoing curative surgery.
abstract: BACKGROUND
  To investigate the role of epidermal growth factor receptor (EGFR) expression as a prognostic marker for prediction of cancer behavior and clinical outcomes in colon cancer patients undergoing potentially curative surgery.
  
  
  METHODS
  EGFR determination using a commercially available immunohistochemistry kit was performed in tissues from 149 colon cancer patients receiving primary surgical treatment and in 25 normal colon mucosa specimens from noncancer patients. EGFR positivity was correlated in univariate and multivariate analyses with disease recurrence and survival. In addition, p27, p53, and vascular endothelial growth factor expression were assessed by immunohistochemistry in 104 patients and correlated with EGFR tumor expression and clinical outcome.
  
  
  RESULTS
  EGFR expression was detected in approximately one third of colon cancer patients (53 of 149; 35.6%). In 126 curatively treated patients, EGFR expression was correlated with disease recurrence and worse survival in both univariate and multivariate analyses. In a multivariate model for predicting recurrence and survival, Dukes' staging, p27, and EGFR expression were the only independent covariates. In particular, in Dukes' A and B patients the 5-year survival probability was 96% for EGFR-negative and high p27 expression cases and was 30.7% for EGFR-positive and low p27 expression cases.
  
  
  CONCLUSIONS
  EGFR expression was an independent prognostic indicator of disease recurrence and poor survival in colon cancer patients undergoing curative surgery. In the context of novel therapeutic options such as molecularly targeted therapies, these findings suggest that anti-EGFR drugs could be evaluated in the adjuvant treatment of EGFR-positive colon cancer patients.
authors.affiliation: Division of Surgical Oncology, F. Magrassi and A. Lanzara Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, 80131, Italy. gennaro.galizia@unina2.it
authors.forename: Gennaro
authors.initials: G
authors.lastname: Galizia
authors.forename: Eva
authors.initials: E
authors.lastname: Lieto
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferraraccio
authors.forename: Ferdinando
authors.initials: F
authors.lastname: De Vita
authors.forename: Paolo
authors.initials: P
authors.lastname: Castellano
authors.forename: Michele
authors.initials: M
authors.lastname: Orditura
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Imperatore
authors.forename: Anna
authors.initials: A
authors.lastname: La Mura
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Manna
authors.forename: Margherita
authors.initials: M
authors.lastname: Pinto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Catalano
authors.forename: Carlo
authors.initials: C
authors.lastname: Pignatelli
authors.forename: Fortunato
authors.initials: F
authors.lastname: Ciardiello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003110:Colonic Neoplasms / Q000378:metabolism* / Q000601:surgery; D050760:Cyclin-Dependent Kinase Inhibitor p27 / Q000378:metabolism; D018450:Disease Progression; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000473:pathology; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53; D050760:Cyclin-Dependent Kinase Inhibitor p27; D066246:ErbB Receptors