title: Telomerase is an independent prognostic marker of overall survival in patients with colorectal cancer.
abstract: BACKGROUND
  Colorectal cancer (CRC) is an important cause of cancer-related death. Prediction of recurrence is an important issue in the treatment of disease, particularly for stage II patients. The level of telomere-specific reverse transcriptase (hTERT), the catalytic component of the telomerase complex, increases along with CRC progression, but its prognostic value is still unclear.
  
  
  METHODS
  One hundred and thirty-seven CRC patients were studied for hTERT expression in tumour cells by real-time PCR. hTERT level was evaluated as a prognostic factor of overall survival (OS) in all patients and of disease recurrence in a subgroup of 50 stage II patients.
  
  
  RESULTS
  The median hTERT level was 93.8 copies (interquartile range 48-254). Patients with high hTERT levels (above the median) showed a significantly worse survival than those with low hTERT levels (below the median; log-rank test P<0.0001; hazard ratio (HR)=3.30 (95% confidence interval (CI) 1.98-5.52); P<0.0001). The negative prognostic value of high hTERT level is independent of the pathological stage and microsatellite instability (HR=2.09 (95% CI 1.20-3.64), P=0.009). Moreover, in stage II CRC, high hTERT levels identified patients with a higher risk of disease recurrence (HR=3.06 (95% CI 1.03-9.04), P=0.043) and death (HR=3.24 (95% CI 1.37-7.71), P=0.008).
  
  
  CONCLUSIONS
  hTERT level is an independent prognostic marker of OS in CRC patients. In addition, assessment of hTERT level could improve stratification of stage II CRC patients for the risk of disease recurrence.
authors: Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto, IRCCS, Via Gattamelata 64, 35128 Padova, Italy.
authors: R
authors: R
authors: Bertorelle
authors: M
authors: M
authors: Briarava
authors: E
authors: E
authors: Rampazzo
authors: L
authors: L
authors: Biasini
authors: M
authors: M
authors: Agostini
authors: I
authors: I
authors: Maretto
authors: S
authors: S
authors: Lonardi
authors: M L
authors: ML
authors: Friso
authors: C
authors: C
authors: Mescoli
authors: V
authors: V
authors: Zagonel
authors: D
authors: D
authors: Nitti
authors: A
authors: A
authors: De Rossi
authors: S
authors: S
authors: Pucciarelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012333:RNA, Messenger / Q000096:biosynthesis; D019098:Telomerase / Q000032:analysis* / Q000235:genetics / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger; C509186:TERT protein, human; D019098:Telomerase