Epidermal growth factor receptor as a prognostic factor in locally advanced rectal-cancer patients treated with preoperative chemoradiation.
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.
Li
Shengjin
S
Department of Pathology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
Kim
Jae-Sung
JS
Kim
Jin-Man
JM
Cho
Moon-June
MJ
Yoon
Wan-Hee
WH
Song
Kyu-Sang
KS
Yeo
Seung-Gu
SG
Kim
Jun-Sang
JS
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
D009363:Neoplasm Proteins; D066246:ErbB Receptors