title: Ezrin expression predicts local recurrence and development of metastases in soft tissue sarcomas.
abstract: BACKGROUND
  Ezrin is a cytoskeletal protein involved in tumour growth and invasion. Ezrin expression has been suggested to play a role in metastasis in paediatric osteosarcoma and rhabdomyosarcoma.
  
  
  OBJECTIVE
  To evaluate the prognostic role of ezrin in a large series of soft tissue sarcoma of the extremities and trunk wall.
  
  
  METHODS
  Ezrin expression was evaluated by immunohistochemistry on tissue microarrays from a mixed series of 256 soft tissue sarcomas. The expression patterns were correlated to local recurrence and metastasis as well as to established prognostic factors in soft tissue sarcoma.
  
  
  RESULTS
  Increased ezrin expression predicted development of metastasis (HR=1.8, 95% CI 1.1 to 2.8; p=0.007) and local recurrence, also after adjustment for surgical margin (HR=2.4, 95% CI 1.4 to 4.3; p=0.02). Correlations to established prognostic factors showed strong associations between ezrin and necrosis (OR=3.9, p<0.0001) and ezrin and growth pattern (OR=3.1, p=0.03).
  
  
  CONCLUSIONS
  Ezrin independently predicts development of local recurrences and metastases in soft tissue sarcomas. The possibility of preoperative evaluation makes ezrin a potential marker for identification of high-risk sarcoma patients who would benefit from neoadjuvant therapy.
authors.affiliation: Department of Oncology, Institute of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden. ana.carneiro@med.lu.se
authors.forename: Ana
authors.initials: A
authors.lastname: Carneiro
authors.forename: Pär-Ola
authors.initials: PO
authors.lastname: Bendahl
authors.forename: Måns
authors.initials: M
authors.lastname: Åkerman
authors.forename: Henryk A
authors.initials: HA
authors.lastname: Domanski
authors.forename: Anders
authors.initials: A
authors.lastname: Rydholm
authors.forename: Jacob
authors.initials: J
authors.lastname: Engellau
authors.forename: Mef
authors.initials: M
authors.lastname: Nilbert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003598:Cytoskeletal Proteins / Q000378:metabolism*; D005121:Extremities; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D046228:Microarray Analysis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D012509:Sarcoma / Q000175:diagnosis*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis*; D013909:Thorax; D055815:Young Adult; D000099149:Ezrin
chemical_list: D014408:Biomarkers, Tumor; D003598:Cytoskeletal Proteins; D000099149:Ezrin