title: Prognostic value of survivin expression in stage III non-small cell lung cancer patients treated with platinum-based therapy.
abstract: BACKGROUND
  The potential prognostic value of survivin is variably reported depending on the lung cancer stage. This study examines the correlation between tumor survivin expression before and after chemoradiation therapy, therapeutic response, and prognosis in stage III non-small cell lung cancer (NSCLC) patients who were treated with platinum-based chemoradiation therapy and surgery.
  
  
  METHODS
  This retrospective study included stage III NSCLC patients with adequate pre- and posttreatment tumor tissues. Tissues were stained using immunohistochemistry, and the degree of staining was scored. Clinical and biological variables were assessed using univariate and multivariate analyses to determine the prognostic relationship with overall survival (OS) and time to recurrence (TTR).
  
  
  RESULTS
  Fifty-three patients were enrolled. Tumor survivin expression in pretreatment tissues was determined in 47 patients (88.7%). The pretreatment survivin score was unrelated with TTR and OS (p = 0.249 and 0.601, respectively). There was no correlation between the pre- and posttreatment survivin scores (p = 0.309). Downregulated survivin and the posttreatment survivin score (0-1) after chemoradiation were significantly correlated with improved OS (p = 0.04 and p = 0.033, respectively). Age, downregulated survivin score, and posttreatment survivin score (0-1) were significant prognostic factors for survival according to the multivariate analysis.
  
  
  CONCLUSIONS
  Downregulated and low posttreatment survivin scores are prognostic in stage III NSCLC patients who receive platinum-based chemoradiation therapy followed by surgery regardless of the pretreatment survivin score. These results suggest that additional studies on the relationship between survivin and platinum-based chemoradiation therapy are warranted in NSCLC patients.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: scena@dreamwiz.com.
authors.forename: Hyeong Ryul
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong-Hee
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Kwan
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Il
authors.initials: SI
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin; D017239:Paclitaxel; D002945:Cisplatin
keywords: Immunochemistry; Lung cancer biology; Pathology; Tumor markers