This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zellars, R. C. Articles by Elledge, R. M. Search for Related Content PubMed PubMed Citation Articles by Zellars, R. C. Articles by Elledge, R. M. Social Bookmarking                            What's this?

Prognostic Value of p53 for Local Failure in Mastectomy-Treated Breast Cancer Patients

From the Departments of Radiology (Division of Radiation Oncology), Medical Oncology, and Pathology, University of Texas Health Science Center at San Antonio, San Antonio, and Baylor Methodist Breast Center at Baylor College of Medicine, Houston, TX.

Address reprint requests to Richard C. Zellars, MD, Division of Radiation Oncology, Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78284-7800.

PURPOSE: The loss of p53 function is a recognized adverse prognostic factor in invasive breast cancer. Several studies have shown a relationship between the nuclear accumulation of p53 protein (a surrogate marker of p53 inactivation) and poor disease-free and overall survival. In general, however, these studies did not report the prognostic value of p53 for local failure, which we have therefore assessed retrospectively here.

MATERIALS AND METHODS: Accumulation of p53 protein was evaluated by immunohistochemistry in 1,530 mastectomy-treated breast cancer patients (259 radiation therapy [RT]– and 1,271 mastectomy only [No RT]–treated patients). Statistical comparisons were made between p53 protein accumulation, estrogen/progesterone receptors, nodal status, tumor size, and local failure rate (LFR). Local failure was defined as tumor recurrence involving the chest wall and/or the ipsilateral supraclavicular/axillary lymph nodes. The median follow-up period was 62 months.

RESULTS: In the No RT group, the LFR was 9.1% and 16.5% in p53-negative and p53-positive patients, respectively (P < .001). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (relative risk [RR], 1.7; 95% confidence interval [CI], 1.2 to 2.4). Nodal status and tumor size were also significant factors. In the RT group, the LFR was 9.3% and 21.5% in p53-negative and p53-positive patients, respectively (P = .009). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (RR, 2.5; 95% CI, 1.1 to 5.7), as was nodal status.

CONCLUSION: Nuclear accumulation of p53 protein is independently associated with a significantly increased local failure rate in breast cancer patients treated with mastectomy, with or without radiation.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				P. Daftarian, G.-Y. Song, S. Ali, M. Faynsod, J. Longmate, D. J. Diamond, and J. D. I. Ellenhorn Two Distinct Pathways of Immuno-Modulation Improve Potency of p53 Immunization in Rejecting Established Tumors Cancer Res., August 1, 2004; 64(15): 5407 - 5414. [Abstract] [Full Text] [PDF]

				H. H. W. Chen, W.-C. Su, H.-R. Guo, T.-W. Chang, and W.-Y. Lee 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 Jpn. J. Clin. Oncol., September 1, 2002; 32(9): 332 - 339. [Abstract] [Full Text] [PDF]

				L. J. Pierce Treatment Guidelines and Techniques in Delivery of Postmastectomy Radiotherapy in Management of Operable Breast Cancer J Natl Cancer Inst Monographs, December 1, 2001; 2001(30): 117 - 124. [Abstract] [Full Text] [PDF]