title: Epidermal growth factor receptor as a prognostic factor in locally advanced rectal-cancer patients treated with preoperative chemoradiation.
abstract: OBJECTIVE
  We investigated the prognostic value of epidermal growth factor receptor (EGFR) expression in pretreatment biopsy specimens from patients with locally advanced rectal cancer treated with preoperative chemoradiation.
  
  
  METHODS
  Pretreatment biopsy specimens from 92 patients with locally advanced rectal cancer were examined for EGFR expression by immunohistochemistry. EGFR expression was assessed by immunoreactive score (IRS). The prognostic value of EGFR expression was evaluated according to the level of EGFR expression.
  
  
  RESULTS
  Epidermal growth factor receptor expression was positive in 65 patients (71%). EGFR expression levels were low (IRS 0 to 5) in 83 patients (90%) and high (IRS 6 to 7) in 9 patients (10%). A high level of EGFR expression was statistically significant for shorter overall survival (p = 0.013), disease-free survival (p = 0.002), and distant metastasis-free survival (p = 0.003), as compared with a low level of expression in univariate analysis. Grouping based on positive or negative EGFR expression did not represent prognostic significance for survival. In multivariate analysis, high EGFR expression was an independent prognostic factor for decreased disease-free survival (relative risk 2.4, p = 0.041) and distant metastasis-free survival (relative risk 2.6, p = 0.04).
  
  
  CONCLUSIONS
  Our results suggest that high level of EGFR expression in a pretreatment biopsy specimen may be a significant adverse prognostic factor for disease-free survival and distant metastasis-free survival.
authors.affiliation: Department of Pathology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
authors.forename: Shengjin
authors.initials: S
authors.lastname: Li
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Jin-Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Moon-June
authors.initials: MJ
authors.lastname: Cho
authors.forename: Wan-Hee
authors.initials: WH
authors.lastname: Yoon
authors.forename: Kyu-Sang
authors.initials: KS
authors.lastname: Song
authors.forename: Seung-Gu
authors.initials: SG
authors.lastname: Yeo
authors.forename: Jun-Sang
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000532:radiotherapy; D016019:Survival Analysis
chemical_list: D009363:Neoplasm Proteins; D066246:ErbB Receptors