Prognostic significance of c-erbB-2 protein expression in carcinoma of thecervix treated with radiotherapy

Purpose: The relationship was studied between c-erbB-2 expression and outco me in 107 carcinomas of the cervix treated with radical radiotherapy. Metho ds: Formalin-fixed, paraffin-embedded sections were stained by immunohistoc hemistry for over-expression of the c-erbB-2 protein. A retrospective study of treatment outcome was made on patients with a median follow-up of 55 mo nths. Results: Patients with c-erbB-2-positive tumours had a significantly worse overall survival rate than those with c-erbB-2-negative tumours (P = 0.019). Metastasis-free survival (i.e. recurrence outside the radiotherapy field) was also significantly worse (P < 0.001) but there were no differenc es in local control (i.e. recurrence within the radiotherapy field) rates ( P = 0.24). Bivariate log-rank analyses showed that the prognostic value of c-erbB-2 expression for metastasis-free survival was independent of disease stage, histological grade, patient age, tumour size and tumour radiosensit ivity. A combination of two biological parameters yielded a high discrimina tion between outcome groups. Women with radiosensitive and c-er-bB-2-negati ve tumours had a 5-year metastasis-free survival level of 70% compared to 3 3% for women with radioresistant, c-erbB-2-positive tumours. Conclusions: c -erbB-2 expression is an important prognostic factor for determining tumour recurrence outside the treatment field in cervix carcinomas treated with r adiotherapy.