title: Heat shock protein 70 as a predictive marker for platinum-based adjuvant chemotherapy in patients with resected non-small cell lung cancer.
abstract: OBJECTIVE
  Although adjuvant platinum-based chemotherapy improves survival in completely resected non-small cell lung cancer (NSCLC), its effect is limited. We evaluated whether the expression of heat shock protein 70 (Hsp70) is associated with clinical outcomes in patients with completely resected NSCLC who were treated with or without adjuvant platinum-based chemotherapy.
  
  
  METHODS
  Patients who underwent curative resection for NSCLC and diagnosed as stage IIA through IIIA were included. Immunohistochemical staining for Hsp70 was performed on surgical specimens and survival rates were compared by Hsp70 expression and adjuvant platinum-based chemotherapy.
  
  
  RESULTS
  Of 327 enrolled patients, Hsp70 expression was positive in 220 (67.3%). For patients who did not receive adjuvant chemotherapy, Hsp70 expression did not significantly affect survival. However, for patients who received adjuvant chemotherapy, those with Hsp70-positive tumors had a longer disease-free survival outcome than cases with Hsp70-negative tumors (not reached vs. 27.3 months; P=0.002), although there was no significant difference in overall survival (97.0 vs. 58.9 months, P=0.080). In the adjuvant chemotherapy group, multivariate modeling showed that patients with Hsp70-postitive tumors had a lower risk of recurrence and death after adjusting for age, sex, performance status, pathologic stage, and histological type (disease-free survival: adjusted hazard ratio, 0.537; 95% CI, 0.362-0.796; P=0.002; overall survival: adjusted hazard ratio, 0.663; 95% CI, 0.419-1.051; P=0.080).
  
  
  CONCLUSIONS
  Hsp70 is a positive predictive factor in completely resected NSCLC with received platinum-based adjuvant chemotherapy.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Tai Sun
authors.initials: TS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea.
authors.forename: Hye-Ryoun
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Department of Pathology, Korea Cancer Center Hospital, Seoul, Republic of Korea.
authors.forename: Jae Soo
authors.initials: JS
authors.lastname: Koh
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Jang
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Ho Il
authors.initials: HI
authors.lastname: Yoon
authors.affiliation: Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Jin-Haeng
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea.
authors.forename: Cheol Hyeon
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Healthcare Management, Cheongju University, Cheongju, Republic of Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jungmin
authors.initials: J
authors.lastname: Jo
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Cheol
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: ccm@amc.seoul.kr.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015415:Biomarkers; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010984:Platinum / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018840:HSP70 Heat-Shock Proteins; D010984:Platinum
keywords: Adjuvant chemotherapy; Biologic markers; Heat shock protein 70; Non-small cell lung cancer; Survival analysis; Treatment outcome