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Catalytic subunit of human telomerase reverse transcriptase is an independent predictor of survival in patients undergoing curative resection of hepatic colorectal metastases: a multicenter analysis.

AbstractPURPOSE:
To determine the role of the catalytic subunit of human telomerase reverse transcriptase (hTERT) in predicting survival after resection of hepatic colorectal metastases (CRM).
PATIENTS AND METHODS:
Two hundred one patients who underwent curative resection of hepatic CRM between 1990 and 2000 were identified from a multicenter database. The CRM were analyzed for hTERT nucleolar expression by standard immunohistochemical techniques. hTERT expression and known clinicopathologic factors of survival were examined.
RESULTS:
With a median follow-up of 80 months, 152 patients (75.6%) had died; the 5-year overall survival was 30.7%. On univariate analysis, number of metastases greater than two (P = .0005), extrahepatic disease (P = .0054), disease-free interval less than 12 months (P = .006), carcinoembryonic antigen level greater than 200 ng/mL (P = .0071), and positive hTERT nucleolar staining (P < .0001) were associated with decreased survival. On multivariate analysis, three factors independently predicted survival: number of metastases (relative risk [RR] = 1.74; P = .0011); disease-free interval (RR = 1.70; P = .0035); and positive hTERT nucleolar staining (RR = 2.03; P < .0001). Patients with none or one of these factors had a 5-year survival rate of 48%, whereas those with two or three of these factors had a 5-year survival of 15% (P < .0001).
CONCLUSION:
hTERT nucleolar expression is associated with worse survival after resection of hepatic CRM. hTERT expression in conjunction with number of hepatic metastases and disease-free interval may permit more accurate prediction of survival after resection of hepatic CRM.
AuthorsJulien Dômont, Timothy M Pawlik, Valérie Boige, Mathieu Rose, Jean-Christophe Weber, Paulo M Hoff, Thomas D Brown, Daria Zorzi, Luc Morat, Jean-Pierre Pignon, Asif Rashid, Daniel Jaeck, Laure Sabatier, Dominique Elias, Thomas Tursz, Jean-Charles Soria, Jean-Nicolas Vauthey
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 23 Issue 13 Pg. 3086-93 (May 1 2005) ISSN: 0732-183X [Print] United States
PMID15860868 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • DNA-Binding Proteins
  • Telomerase
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Catalytic Domain
  • Colorectal Neoplasms (genetics, pathology)
  • DNA-Binding Proteins
  • Female
  • Gene Expression Profiling
  • Humans
  • Immunohistochemistry
  • Liver Neoplasms (genetics, secondary, surgery)
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Metastasis (genetics)
  • Predictive Value of Tests
  • Prognosis
  • Survival Analysis
  • Telomerase (genetics)

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