title: Epidermal growth factor receptor expression as prognostic marker in patients with anal carcinoma treated with concurrent chemoradiation therapy.
abstract: OBJECTIVE
  To investigate the prognostic value of epidermal growth factor receptor (EGFR) expression in pretreatment tumor biopsy specimens of patients with anal cancer treated with concurrent 5-fluorouracil and mitomycin C-based chemoradiation therapy (CRT).
  
  
  METHODS
  Immunohistochemical staining for EGFR was performed in pretreatment biopsy specimens of 103 patients with anal carcinoma. EGFR expression was correlated with clinical and histopathologic characteristics and with clinical endpoints, including local failure-free survival (LFFS), colostomy-free survival (CFS), distant metastases-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS).
  
  
  RESULTS
  EGFR staining intensity was absent in 3%, weak in 23%, intermediate in 36% and intense in 38% of the patients. In univariate analysis, the level of EGFR staining was significantly correlated with CSS (absent/weak vs intermediate/intense expression: 5-year CSS, 70% vs 86%, P=.03). As a trend, this was also observed for DMFS (70% vs 86%, P=.06) and LFFS (70% vs 87%, P=.16). In multivariate analysis, N stage, tumor differentiation, and patients' sex were independent prognostic factors for CSS, whereas EGFR expression only reached borderline significance (hazard ratio 2.75; P=.08).
  
  
  CONCLUSIONS
  Our results suggest that elevated levels of pretreatment EGFR expression could be correlated with favorable clinical outcome in anal cancer patients treated with CRT. Further studies are warranted to elucidate how EGFR is involved in the response to CRT.
authors.affiliation: Department of Radiotherapy and Oncology, Goethe University, Frankfurt/Main, Germany. inge.fraunholz@kgu.de
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Fraunholz
authors.forename: Franz
authors.initials: F
authors.lastname: Rödel
authors.forename: Daniela
authors.initials: D
authors.lastname: Kohler
authors.forename: Margarita
authors.initials: M
authors.lastname: Diallo-Georgiopoulou
authors.forename: Luitpold
authors.initials: L
authors.lastname: Distel
authors.forename: Stefan
authors.initials: S
authors.lastname: Falk
authors.forename: Claus
authors.initials: C
authors.lastname: Rödel
mesh_terms: D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000737:chemistry / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009363:Neoplasm Proteins / Q000032:analysis / Q000378:metabolism*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D009363:Neoplasm Proteins; D016685:Mitomycin; D066246:ErbB Receptors; D005472:Fluorouracil