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Japanese Journal of Clinical Oncology 32:332-339 (2002)
© 2002 Foundation for Promotion of Cancer Research

p53 and c-erbB-2 but Not bcl-2 are Predictive of Metastasis-free Survival in Breast Cancer Patients Receiving Post-mastectomy Adjuvant Radiotherapy in Taiwan

Helen H. W. Chen1, Wu-Chou Su2, How-Ran Guo3, Tsai-Wang Chang4 and Wen-Ying Lee5,+

Departments of 1 Radiation Oncology, 2 Internal Medicine, 4 Surgery and 5 Pathology, National Cheng Kung University Hospital and 3 Graduate Institute of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Background: Patients with breast cancer often receive radiotherapy after mastectomy if they are at a high risk of local recurrence, but the prognosis varies among patients. We conducted a study to evaluate p53, bcl-2 and c-erbB-2 as predictors of prognosis in breast cancer patients receiving post-mastectomy radiotherapy, which has not been well defined in the Taiwanese population.

Methods: We recruited 74 consecutive patients with primary operable breast cancer who were treated with mastectomy followed by locoregional radiotherapy and studied the presence of p53, bcl-2 and c-erbB-2 expressions in tumor tissues by immunohistochemical staining. Associations between the protein expressions and clinical outcomes, including local recurrence-free survival (LRFS), metastasis-free survival (MFS) and overall survival (OS), were evaluated.

Results: The median follow-up time was 55 months. Expressions of p53, bcl-2 and c-erbB-2 were observed in 14 (19%), 28 (38%) and 39 (53%) patients, respectively. Both p53 and c-erbB-2 were significant predictors of MFS. The 5-year MFS for p53-negative and p53-positive tumors were 61.2 and 35.7% (P = 0.01) and 5-year MFS for c-erbB-2-negative and c-erbB-2-positive tumors were 71.3 and 42.4% (P = 0.01). Whereas expression of bcl-2 protein is associated with favorable clinicopathological features, it was not related to LRFS, MFS or OS. Multivariate analyses confirmed c-erbB-2 and p53 expressions as predictors of MFS independent of tumor size, histological grading and lymph node involvement.

Conclusion: Expressions of p53 and c-erbB-2 are independent predictors of MFS in this Taiwanese population. Further research should be conducted on their application in the treatment and follow-up of patients.

+ For reprints and all correspondence: Wen-Ying Lee, Department of Pathology, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, Taiwan. E-mail: leewy@mail.ncku.edu.tw


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