Prognostic Significance of p27(kip1) Expression in Node Negative Colorectal Carcinoma

ABSTRACT

PURPOSE: Dukes' A & B colorectal cancer patients are often excluded from adjuvant chemotherapy following potentially curative surgery because they are expected to have good long-term survival. However, actually 20 ~ 30% of these patients suffer from recurrent disease, so it would be helpful for these patients of recurrent disease to be able to select a high risk group. METHODS: In 78 Dukes' A & B colorectal cancers, we investigated by immunohistochemistry the role of molecular markers, such as p27(kip1), p53, Ki-67, and Skp2, in identifying high-risk patients. RESULTS: Patients with low p27(kip1) expression showed poor overall survival compared to those with high p27(kip1) expressions (55.3 versus 66.7 months, P=0.018). The only significant factor associated with p27(kip1) expression was p53 expression. The low p27(kip1) expression and positive p53 expression group had poor overall survival (54.3 months, P=0.036). CONCLISIONS In a node-negative colorectal carcinoma, the molecular marker p27(kip1) does not play an independent prognostic role, but it may have prognostic significance in correlation with other markers such as p53, Ki-67, and Skp2. The assessment of molecular alterations may be useful to node-negative colorectal patients in identifying the high risk group that may benefit from adjuvant chemotherapy.