EXPRESSION OF P53 AND P21 ARE INDEPENDENT PROGNOSTIC FACTORS IN PATIENTS WITH SEROSAL INVASION BY GASTRIC-CARCINOMA

To evaluate whether the expression of p53 and that of p21 are independ ent prognostic factors in patients with advanced gastric cancer, we in vestigated clinicopathological factors and the expression of p53 and p 21 in 158 patients with gastric cancer that had invaded the serosa and who had undergone curative gastrectomy. In multivariate survival anal ysis of 156 surviving patients, we evaluated the size of the tumor, ly mph node metastasis, venous invasion, lymph node dissections expressio n of p53, and expression of p21 as independent prognostic factors. Mor eover, we divided patients into four groups according to the expressio n of p53 and p21 in their tumors [group A. p53(-)/p21(-), N = 40 (one died within 30 days of surgery); group B, p53(-)/p21(+), N = 23; group C, p53(+)/p21(-), N = 58; and group D, p53(+)/p21(+), N = 37 (one die d within 30 days of surgery)]. The 5- and 10-year survival rates of 39 patients in group A were 71.7% and 64.3%, those of 23 patients in gro up B were 81.4% and 81.4%, those of 58 patients in group C were 35.6% and 30.2%, and those of 36 patients in group D were 67.9% and 60.7%. T he prognosis of patients in group C was poorer than that of patients i n the other three groups. This result indicates that the evaluation of the expression of both p53 and p21 expression might provide prognosti c information that is more accurate than that provided by evaluation o f the expression of p53 alone.