Elevated cyclooxygenase-2 expression correlates with diminished survival in carcinoma of the cervix treated with radiotherapy

Purpose: The purpose of this study,vas to examine the relationship between overall survival and prognostic factors in carcinoma of the cervix treated with radiation therapy. A clinicopathologic study was performed on 24 patie nts. Methods and Materials: Formalin-fixed, paraffin-embedded tumor biopsies wer e stained for Cyclooxygenase-2 (COX-2), Topoisomerase I, Topoisomerase II, and p53. Clinical factors such as stage, grade, tumor size, pre- and post-t reatment hemoglobin level, and radiotherapy dose were also evaluated. Results: Median follow-up was 75 months for living patients. The only immun ohistochemical or clinical factor that was associated with improved surviva l was decreased COX-2 distribution staining. High COX-2 distribution staini ng was associated,vith decreased overall survival (p = 0.021) and decreased disease-free survival (p = 0.015) by log-rank comparison of Kapian-Meier s urvival curves. The 5-year overall survival rates for tumors with low vs. h igh COX-2 distribution values were 75% and 35%, respectively. COX-2 stainin g intensity was found to correlate positively with tumor size (p = 0.022). Conclusion: These findings indicate that increased expression of COX-2 port ends a diminished survival in patients with invasive carcinoma of the cervi x treated with radiotherapy. Because COX-2 is an early-response gene involv ed in angiogenesis and inducible by different stimuli, these data may indic ate opportunity to intervene with specific inhibitors of COX-2 in carcinoma of the cervix, (C) 2001 Elsevier Science.