NUCLEAR P53 PROTEIN EXPRESSION IN RESECTED HEPATIC METASTASES FROM COLORECTAL-CANCER - AN INDEPENDENT PROGNOSTIC FACTOR OF SURVIVAL

An association has been reported between nuclear p53 protein expressio n in tumour cells and a poor outcome in patients with colorectal cance r (CRC). In this study we investigated the prognostic significance of nuclear p53 protein expression in CRC liver metastases after curative hepatic resection. The study population consisted of 69 consecutive pa tients who underwent curative hepatic resection for metastases from CR C at our Institution between February 1987 and October 1993. Immunohis tochemical expression of p53 protein was evaluated in formalin-fixed p araffin-embedded sections of CRC liver metastases using the monoclonal antibodies (MAbs) D01 and Pab 1801. The Cox proportional hazards mode l was used in forward stepwise regression to assess the relative influ ence of different prognostic factors. Forty-four (63.8%) CRC liver met astases were p53-positive. Kaplan-Meier survival curves demonstrated t hat patients with p53-positive metastases had a median survival of 27 months versus 93 months for patients with p53-negative metastases (P<0 .01). The 3 and 5 year survival rates were 31.5 and 21.0% in patients with p53-positive metastases and 71.8 and 53.1% in patients with p53-n egative metastases. At multivariate analysis p53 protein status was th e single best predictor of survival (P=0.0079); the odds ratio of deat h among patients with p53-positive tumours was 2.53. Nuclear p53 prote in expression in hepatic metastases from CRC is an independent prognos tic factor of survival following liver resection. These findings may b e of clinical importance in the selection of patients more likely to b enefit from liver resection and could be used as criteria for stratifi cation in trials on adjuvant therapy. (C) 1998 Elsevier Science Ltd. A ll rights reserved.