Survivin Expression Can Predict the Effect of Chemoradiotherapy for Advanced Lower Rectal Cancer
Overview
Authors
Affiliations
Background: Chemoradiotherapy (CRT) has been used to improve local control and survival in patients with advanced rectal carcinoma. However, a significant proportion of patients show poor response to adjuvant CRT. We thus investigated the usefulness of survivin expression as a predictive marker of the CRT response and its characteristics.
Methods: Forty-three patients with lower rectal cancer who underwent CRT were investigated. All patients received preoperative CRT consisting of TS-1 concurrent with 40 Gy of pelvic irradiation followed by curative resection. The relationship between clinical response, or pathological response, and the expression of survivin of pre-CRT biopsy specimens was evaluated by immunohistochemistry and compared with post-CRT expression.
Results: Positive expression of survivin was observed in 26 of 43 patients (60%) in pre-CRT specimens. Survivin was positively expressed in 77% of stable disease cases, and 43% of partial response (p < 0.05). Regarding the correlation between pathological response and survivin expression, positive expression of survivin was recognized in 75% (18 of 24) of Grade 0 + 1 cases, 50% (7 of 14) of Grade 2 cases, and 20% (1 of 5) of Grade 3 cases. A reverse correlation was recognized between pathological responses and survivin expression (p < 0.05). There were differences in the tumor differentiation between the survivin-positive group and the negative group (p < 0.05). The expression concordance rate was 66% between pre- and post-CRT tissues. In post-CRT tissues, nuclear survivin expression disappeared completely and cytoplasmic expression increased, especially in responder cases.
Conclusion: Survivin expression in biopsy could be an important predictive factor of preoperative CRT response.
Takasu C, Nishi M, Yoshikawa K, Tokunaga T, Nakao T, Kashihara H BMC Cancer. 2022; 22(1):1263.
PMID: 36471264 PMC: 9720962. DOI: 10.1186/s12885-022-10357-1.
Monitoring survivin expression in cancer: implications for prognosis and therapy.
Guindalini R, Mathias Machado M, Garicochea B Mol Diagn Ther. 2013; 17(6):331-42.
PMID: 23912862 DOI: 10.1007/s40291-013-0048-1.
Prognostic and clinicopathological significance of survivin in colorectal cancer: a meta-analysis.
Krieg A, Werner T, Verde P, Stoecklein N, Knoefel W PLoS One. 2013; 8(6):e65338.
PMID: 23755220 PMC: 3670901. DOI: 10.1371/journal.pone.0065338.