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Medline ® Abstract for Reference 87

of 'Adjuvant chemotherapy for resected stage II colon cancer'

87
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The DCC protein and prognosis in colorectal cancer.
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Shibata D, Reale MA, Lavin P, Silverman M, Fearon ER, Steele G Jr, Jessup JM, Loda M, Summerhayes IC
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N Engl J Med. 1996;335(23):1727.
 
BACKGROUND: Allelic loss of chromosome 18q predicts a poor outcome in patients with stage II colorectal cancer. Although the specific gene inactivated by this allelic loss has not been elucidated, the DCC (deleted in colorectal cancer) gene is a candidate. We investigated whether the expression of the DCC protein in tumor cells is a prognostic marker in colorectal carcinoma.
METHODS: The expression of DCC was evaluated immunohistochemically in 132 paraffin-embedded samples from patients with curatively resected stage II and III colorectal carcinomas. The Cox proportional-hazards model was used to adjust for covariates including age, sex, tumor site, degree of tumor differentiation, and use of adjuvant therapy.
RESULTS: The expression of DCC was a strong positive predictive factor for survival in both stage II and stage III colorectal carcinomas. In patients with stage II disease whose tumors expressed DCC, the five-year survival rate was 94.3 percent, whereas in patients with DCC-negative tumors, the survival rate was 61.6 percent (P<0.001). In patients with stage III disease, the respective survival rates were59.3 percent and 33.2 percent (P=0.03).
CONCLUSIONS: DCC is a prognostic marker in patients with stage II or stage III colorectal cancer. In stage II colorectal carcinomas, the absence of DCC identifies a subgroup of patients with lesions that behave like stage III cancers. These findings may thus have therapeutic implications in this group of patients.
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Department of Surgery, New England Deaconess Hospital, Harvard Medical School, Boston, MA 02215, USA.
PMID