P53 overexpression in colorectal metastases confined to the liver and outcome of liver resection

BACKGROUND/AIMS: The results of hepatic surgery for colorectal metastases a re distorted by the high incidence of recurrence, despite an apparently rad ical resection. Selection of high-risk patients is a mandatory step towards effective application of neo-adjuvant chemotherapy. In this study, express ion of the tumor suppresser gene p53 in colorectal liver metastases was cor related with recurrence after resection. METHODOLOGY: In a retrospective case-series p53 expression was assessed usi ng standard immunohistochemical methods in the paraffin-embedded specimens of 45 liver resections for colorectal metastases, performed in 43 patients in a single institution between '86 and '96. Hospital and office charts wer e reviewed and follow-up was completed with a General Physicians' questionn aire in October '97. Relapse-free and cancer-specific survival from diagnos is of hepatic metastases were assessed and compared for p53+ and p53- group s. RESULTS: Median survival was 36 months with an estimated 5-year cancer-spec ific survival of 43% (95% confidence interval 35%-51%). Relapse-free and ca ncer-specific survival were not significantly different between p53+ (n=24, 53%) and p53- (n=21) groups (P=0.86 and P=0.91 respectively). P53 expressi on was not associated with other potential predictors, which were not of pr edictive value either. CONCLUSIONS: Patients at risk for recurrent disease following partial hepat ectomy for colorectal metastases cannot be identified by p53 expression.