Characterization of p53 mutations in colorectal liver metastases and correlation with clinical parameters

The presence and type of mutations of the p53 tumor suppressor gene were de termined in 40 patients undergoing curative hepatic resection for metastati c colorectal carcinoma. This represents the largest series in the literatur e on the screening of p53 mutations for liver metastases, The analysis was performed in exons 5-9 by denaturing gradient gel electrophoresis followed by direct sequencing. Forty-five percent of tumors showed mutation in p53, and this was observed only in exons 5-8, Mutations at codon positions 167, 196, 204, 213, 245, 281, 282, 286, and 306; deletion of codon 251 and of th e first nucleotide of codon 252; and Leu residue (CTC) insertion downstream codon 252 are reported for the first time in colorectal liver metastasis, Mutations at codon positions 163, 248, and 273 have been reported previousl y. Correlation of p53 status with clinical parameters showed that patients with mutated p53 had a statistically higher number of lesions when compared with patients with wild-type p53 (P < 0.050), In particular, of patients w ith mutated p53, 41% had three or more metastases compared with 14% of pati ents with wild-type p53, Synchronous metastases were present in 70% of the patients with p53 mutations and in only 29% of patients with wild-type p53 (P < 0.025), In addition, patients with p53 mutations are more likely to de velop recurrence (73%) compared with patients with wild-type p53 (33%; P < 0.001), Other factors considered, including preoperative carcinoembryonic a ntigen level, bilobar distribution, and size of the lesion(s), did not show significant correlation with p53 status. These results suggest that p53 st atus might be an important prognostic indicator to predict the pattern and likelihood of treatment failure after hepatic resection.