title: Prognostic value of abnormal p53 expression in locally advanced prostate cancer treated with androgen deprivation and radiotherapy: a study based on RTOG 9202.
abstract: OBJECTIVE
  The goal of this study was to verify the significance of p53 as a prognostic factor in Radiation Therapy Oncology Group 9202, which compared short-term androgen deprivation (STAD) with radiation therapy (RT) to long-term androgen deprivation + RT in men with locally advanced prostate cancer (Pca).
  
  
  METHODS
  Tumor tissue was sufficient for p53 analysis in 777 cases. p53 status was determined by immunohistochemistry. Abnormal p53 expression was defined as 20% or more tumor cells with positive nuclei. Univariate and multivariate Cox proportional hazards models were used to evaluate the relationships of p53 status to patient outcomes.
  
  
  RESULTS
  Abnormal p53 was detected in 168 of 777 (21.6%) cases, and was significantly associated with cause-specific mortality (adjusted hazard ratio [HR] = 1.89; 95% confidence interval (CI) 1.14 - 3.14; p = 0.014) and distant metastasis (adjusted HR = 1.72; 95% CI 1.13-2.62; p = 0.013). When patients were divided into subgroups according to assigned treatment, only the subgroup of patients who underwent STAD + RT showed significant correlation between p53 status and cause-specific mortality (adjusted HR = 2.43; 95% CI = 1.32-4.49; p = 0.0044). When patients were divided into subgroups according to p53 status, only the subgroup of patients with abnormal p53 showed significant association between assigned treatment and cause-specific mortality (adjusted HR = 3.81; 95% CI 1.40-10.37; p = 0.0087).
  
  
  CONCLUSIONS
  Abnormal p53 is a significant prognostic factor for patients with prostate cancer who undergo short-term androgen deprivation and radiotherapy. Long-term androgen deprivation may significantly improve the cause-specific survival for those with abnormal p53.
authors: Department of Pathology, Wayne State University, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA. mingxinche@hotmail.com
authors: Mingxin
authors: M
authors: Che
authors: Michelle
authors: M
authors: DeSilvio
authors: Alan
authors: A
authors: Pollack
authors: David J
authors: DJ
authors: Grignon
authors: Varagur Mohan
authors: VM
authors: Venkatesan
authors: Gerald E
authors: GE
authors: Hanks
authors: Howard M
authors: HM
authors: Sandler
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000726:Androgen Antagonists / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002423:Cause of Death; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008297:Male; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D000726:Androgen Antagonists; D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53
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