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Previous Volume 335:1727-1732 December 5, 1996 Number 23 Next

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ABSTRACT

Background Allelic loss of chromosome 18q predicts a poor outcome in patients with stage II colorectal cancer. Although the specific gene inactivated by this allelic loss has not been elucidated, the DCC (deleted in colorectal cancer) gene is a candidate. We investigated whether the expression of the DCC protein in tumor cells is a prognostic marker in colorectal carcinoma.

Methods The expression of DCC was evaluated immunohistochemically in 132 paraffin-embedded samples from patients with curatively resected stage II or III colorectal carcinomas. The Cox proportional-hazards model was used to adjust for covariates including age, sex, tumor site, degree of tumor differentiation, and use of adjuvant therapy.

Results The expression of DCC was a strong positive predictive factor for survival in both stage II and stage III colorectal carcinomas. In patients with stage II disease whose tumors expressed DCC, the five-year survival rate was 94.3 percent, whereas in patients with DCC-negative tumors, the survival rate was 61.6 percent (P<0.001). In patients with stage III disease, the respective survival rates were 59.3 percent and 33.2 percent (P = 0.03).

Conclusions DCC is a prognostic marker in patients with stage II or stage III colorectal cancer. In stage II colorectal carcinomas, the absence of DCC identifies a subgroup of patients with lesions that behave like stage III cancers. These findings may thus have therapeutic implications in this group of patients.

Source Information

From the Laboratory of Cancer Biology, Department of Surgery (D.S., G.S., J.M.J., I.C.S.), and the Department of Pathology (M.L.), New England Deaconess Hospital, Harvard Medical School, Boston; the Section of Medical Oncology, Yale University School of Medicine, New Haven, Conn. (M.A.R.); the Boston Biostatistics Research Foundation, Framingham, Mass. (P.L.); the Department of Pathology, Lahey–Hitchcock Medical Center, Burlington, Mass. (M.S.); and the Division of Molecular Medicine and Genetics, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor (E.R.F.).

Address reprint requests to Dr. Summerhayes at the Laboratory of Cancer Biology, SWRL 3, Department of Surgery, New England Deaconess Hospital, 1 Deaconess Rd., Boston, MA 02215.

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The DCC Protein and Colon Cancer
Swaim M. W., Ghnassia J.-P., Vikram B., Shibata D., Loda M., Summerhayes I. C.
Extract | Full Text  
N Engl J Med 1997; 336:1456-1457, May 15, 1997. Correspondence

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