The significance of p53 mutations as an indicator of the biological behavior of recurrent hepatocellular carcinomas

The significance of p53 mutations in the primary lesion for recurrent hepat ocellular carcinoma (HCC) was evaluated. Mutations of p53 were examined usi ng nonradioisotopic (nonRI)-polymerase chain reaction (PCR)-single strand c onformation polymorphism (SSCP) in 98 resected HCCs. Of the 98 cases, 25 (2 6%) had a p53 mutation. In 83 patients who survived surgery, the presence o f a p53 mutation was associated with a shortened overall survival (P < 0.00 1) and a shortened cancer-free survival (P < 0.05). In 43 patients who deve loped recurrence, there was no statistically significant correlation betwee n the status of p53 in the primary lesion and the clinical features of recu rrent HCCs examined, i.e., extrahepatic metastasis, the number of recurrent tumors, extent of recurrent tumors, and treatment for recurrent tumors. Ho wever, postrecurrence survival was significantly lower in patients in whom a p53 mutation had been detected in the primary lesion (P < 0.01). A multiv ariate analysis for prognostic value after recurrence revealed that the p53 mutation was a useful independent prognostic factor affecting survival aft er recurrence (P < 0.01). In conclusion, our findings suggest that HCCs wit h p53 mutations have a high malignant potential based on their poor prognos is. Therefore, a p53 mutation in the primary lesion is useful as an indicat or of the biological behavior of recurrent HCCs.