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.

To determine the role of the catalytic subunit of human telomerase reverse transcriptase (hTERT) in predicting survival after resection of hepatic colorectal metastases (CRM).
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.
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).
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
  • 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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