Dr Zlobec and colleagues from Switzerland established an immunohistochemical protein profile to complement preoperative staging, and identify rectal cancer patients at high-risk of adverse outcome.
Immunohistochemistry was performed on a tissue microarray including 482 rectal cancers for APAF-1, EphB2, MST1, Ki67, p53, RHAMM, RKIP and CD8+ tumor infiltrating lymphocytes.
|5-year survival rates for RHAMM+/tumor infiltrating lymphocytes-negative patients were 30%|
|British Journal of Cancer|
After resampling of the data and multivariable analysis, the most reproducible markers were combined and prognosis evaluated as stratified by pT and pN status.
In multivariable analysis, only positive RHAMM, and loss of CD8+ tumor infiltrating lymphocytes were independent prognostic factors.
The 5-year cancer-specific survival rate for RHAMM+/tumor infiltrating lymphocytes-negative patients was 30% compared to 76% for RHAMM-/tumor infiltrating lymphocytes-positive patients.
The 5-year cancer-specific survival of T1/T2/RHAMM+/tumor infiltrating lymphocytes-negative patients was 48%.
The team noted that the 5-year cancer-specific survival of T3/T4/RHAMM-/tumor infiltrating lymphocytes-positive patients was 71%.
Stratifying by nodal status, only N+/RHAMM+/tumor infiltrating lymphocytes-negative patients demonstrated a worse prognosis than N0/RHAMM+/tumor infiltrating lymphocytes-negative patients.
Dr Zlobec’s team commented, “Loss of CD8+ tumor infiltrating lymphocytes was predictive of local recurrence in RHAMM+ tumors only.”
“RHAMM and CD8+ tumor infiltrating lymphocytes may assist in identifying early stage rectal cancer patients facing a particularly poor prognosis and who may derive a benefit from preoperative therapy.”