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Prognostic value of Smac expression in rectal cancer patients treated with neoadjuvant therapy

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Abstract

The objective was to evaluate expression of second mitochondria-derived activator of caspase (Smac) expression before and after treatment in patients treated with preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer and to correlate the clinicopathological characteristics and level of Smac expression with pathologic response and outcome. Expression of biomarker was evaluated by immunohistochemistry in tumor samples from 98 patients with clinical Stage II and III rectal cancer treated with preoperative pelvic radiotherapy plus concurrent chemotherapy. All patients received a standardized total mesorectal excision procedure after a long interval of 4–6 weeks. For Smac, patients with a good response to neoadjuvant CRT tended to have higher pre-therapy levels (P = 0.007). The level of Smac expression decreased after neoadjuvant therapy (P = 0.016). High expression of Smac before CRT, and high Dworak’s tumor regression grade (TRG) were significantly associated with improved 5-year disease-free survival (P < 0.05). Pretreatment nodal status also was significantly associated with 5-year disease-free survival and 5-year local relapse-free survival (P < 0.05). Multivariate analysis confirmed that the pretreatment expression of Smac and Lymph nodal status were independent prognostic factors. Our study suggests that high expression of Smac before neoadjuvant CRT could predict good outcome in locally advanced rectal cancer patients.

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Authors and Affiliations

  1. Department of Radiation Oncology, Shandong Tumor Hospital, Jinan, 250117, China

    Hongjiang Yan, Jinming Yu, Renben Wang, Shumei Jiang & Kunli Zhu

  2. Department of Pathology, Shandong Tumor Hospital, Jinan, 250117, China

    Dianbin Mu

  3. Department of General Surgery, Shandong Tumor Hospital, Jinan, 250117, China

    Zhongfa Xu

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  1. Hongjiang Yan
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  2. Jinming Yu
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  3. Renben Wang
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  4. Shumei Jiang
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  5. Kunli Zhu
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  6. Dianbin Mu
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  7. Zhongfa Xu
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Correspondence to Renben Wang.

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Yan, H., Yu, J., Wang, R. et al. Prognostic value of Smac expression in rectal cancer patients treated with neoadjuvant therapy. Med Oncol 29, 168–173 (2012). https://doi.org/10.1007/s12032-011-9819-x

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  • DOI: https://doi.org/10.1007/s12032-011-9819-x

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