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. 2012 Jun 14:7:88.
doi: 10.1186/1748-717X-7-88.

High survivin expression as a risk factor in patients with anal carcinoma treated with concurrent chemoradiotherapy

Ingeborg Fraunholz  1 , Claus Rödel, Luitpold Distel, Marget Rave-Fränk, Daniela Kohler, Stefan Falk, Franz Rödel
Affiliations

High survivin expression as a risk factor in patients with anal carcinoma treated with concurrent chemoradiotherapy

Ingeborg Fraunholz et al. Radiat Oncol. .

Abstract

Purpose: To investigate the prognostic value of survivin expression in pretreatment specimens from patients with anal cancer treated with concurrent 5-FU and mitomycin C-based chemoradiation (CRT).

Material and methods: Immunohistochemical staining for survivin was performed in pretreatment biopsies of 62 patients with anal carcinoma. Survivin expression was correlated with clinical and histopathological characteristics as well as local failure free- (LFFS), distant metastases free- (DMFS), cancer specific- (CSS), and overall survival (OS).

Results: Survivin staining intensity was weak in 10%, intermediate in 48% and intense in 42% of the patients. No association between survivin expression and clinicopathologic factors (tumor stage, age and HIV status) could be shown. In univariate analysis, the level of survivin staining was significantly correlated with DMFS (low survivin vs. high survivin: 94% vs. 74%, p = 0.04). T-stage, N-stage and the tumor grading were significantly associated with OS and CSS and with DMFS and LFFS, respectively. In multivariate analysis, survivin was confirmed as independent prognostic parameter for DMFS (RR, 0.04; p = 0.02) and for OS (RR, 0.27; p = 0.04).

Conclusion: Our results demonstrated that the level of pretreatment survivin is correlated with the clinical outcome in patients with anal carcinoma treated with concurrent CRT. Further studies are warranted to elucidate the complex role of survivin for the oncologic treatment and to exploit the protein as a therapeutic target in combined modality treatment of anal cancer.

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Figures

Figure 1
Figure 1
Examples of anal cancer biopsies with intense (a), intermediate (b) and weak (c) immunohistochemical staining of survivin in both, cytoplasm and nucleus of tumor cells. Original magnification x 100 (a,b,c) and x 400 (inserts), scale bar: 100 μm.
Figure 2
Figure 2
Distant metastases free survival (DMFS) (a) and Overall survival (OS) (b) according to pretreatment survivin expression (low survivin: weighted score ≤ 8; high survivin: weighted score > 8).
See this image and copyright information in PMC

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