Smad4 may help to identify a subset of colorectal cancer patients with early recurrence after curative therapy.
OBJECTIVE
Loss of Smad4 function is associated with the acquisition of advanced colorectal cancer phenotypes. We investigated the role of Smad4 as a prognostic marker after curative therapy.


METHODS
Four hundred and twenty nine consecutive colorectal cancers were analyzed by tissue microarray-based immunohistochemical assay.


RESULTS
Smad4 protein was expressed in 61.5% (24/39), 53.1% (77/145), 41.3% (78/189) and 34.8% (16/46) of stage I, II, III and IV cancers, respectively. Lymphovascular invasion and lymph node metastasis were strongly correlated with the loss of Smad4 expression (p<0.0001 and p=0.002, respectively). Disease-free survival did not differ between Smad4-positive and Smad4-negative cancers. In stage III disease, time to recurrence after curative therapy was shorter in the Smad4-negative than in the Smad4- positive cancers (20.1±15.1 vs. 34.6 ± 34.1 months, p=0.035).


CONCLUSIONS
Smad4 protein is of no value in predicting recurrence after curative therapy in colorectal cancer, but it may be helpful in identifying a subset of patients with early recurrence after curative therapy.
Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
Byung Kyu
BK
Ahn
Si-Hyong
SH
Jang
Seung Sam
SS
Paik
Kang Hong
KH
Lee
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000737:chemistry*; D009367:Neoplasm Staging; D011379:Prognosis; D051901:Smad4 Protein / Q000032:analysis / Q000502:physiology*; D046888:Tissue Array Analysis
C497796:SMAD4 protein, human; D051901:Smad4 Protein