title: Epidermal growth factor receptor (EGFR) expression is associated with a worse prognosis in gastric cancer patients undergoing curative surgery.
abstract: BACKGROUND
  In gastric cancer, the recurrence rate is high even after curative surgery. A relevant issue is the identification of independent prognostic factors to select high-risk patients; such features can be used as predictive factors for tailored therapies. In this study we have investigated the role of epidermal growth factor receptor (EGFR) expression as a prognostic marker for predicting cancer behavior and clinical outcome in gastric cancer patients undergoing potentially curative surgery.
  
  
  METHODS
  Epidermal growth factor receptor determination using a commercially available immunohistochemistry (IHC) kit was performed in tissues from 82 gastric cancer patients receiving primary surgical treatment and in 25 normal gastric mucosa specimens from noncancer patients. The EGFR positivity was correlated with disease recurrence and survival in univariate and multivariate analyses.
  
  
  RESULTS
  Forty-four percent (36 cases) of gastric cancers were EGFR positive. In 66 curatively treated patients, EGFR expression correlated with disease recurrence and poorer survival in both univariate and multivariate analyses. In a multivariate model for predicting recurrence and survival, advanced tumor extension (T(3) or T(4)), nodal metastases, and EGFR expression were the only independent covariates. In particular, EGFR expression was shown to be a significant predictor of poor prognosis among gastric cancer patients having the same stage according to the current TNM staging system.
  
  
  CONCLUSIONS
  These findings suggest that EGFR expression may be useful in identifying high-risk gastric cancer patients undergoing potentially curative surgery. Multimodal treatments should be considered in the adjuvant treatment of these patients.
authors.affiliation: Division of Surgical Oncology, F. Magrassi - A. Lanzara Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Edificio 17, Via Pansini, Naples, 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: Michele
authors.initials: M
authors.lastname: Orditura
authors.forename: Paolo
authors.initials: P
authors.lastname: Castellano
authors.forename: Anna La
authors.initials: AL
authors.lastname: Mura
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Imperatore
authors.forename: Margherita
authors.initials: M
authors.lastname: Pinto
authors.forename: Anna
authors.initials: A
authors.lastname: Zamboli
authors.forename: Ferdinando
authors.initials: F
authors.lastname: De Vita
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferraraccio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D005748:Gastric Fundus; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011706:Pyloric Antrum; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology / Q000601:surgery
chemical_list: D066246:ErbB Receptors