545P - MMP-9 and Vegfr Expression has Prognostic Significance after Resection for Primary Tumor and Metastatic Site in Colorectal Cancer

Abstract

ABSTRACT Background Resection for metastatic lesion has been commonly done in stage colorectal cancer, showing better survival outcome than other GI malignancy. Although R0 resection in primary and metastatic lesion is done in stage IV cancer, recurrence should be developed and cure is rare. In the present study, we reviewed and analyzed the protein expression and the recurrence to determine the prognostic factor in stage IV colorectal cancer. Method Tissue specimens from 130 patients with metastatic colorectal cancer were analyzed. All patients were diagnosed as metastatic colorectal cancer between Jan, 2000 and Aug, 2008 at Seoul St. Mary's hospital, the Catholic University. We performed immunohistochemical staining using tissue microarray for Wnt 3a, Wnt 5a, VEGFR, and MMP-9. We analyzed the clinicopathological characteristics through the medical record and the association with protein expressions. Result Of the 130 patients, Male was 78 (60%), and female was 52 (40%). Median age was 59.5 years old (range: 27-81). Colon cancer was 76 (58.5%) and rectal cancer was 54 (41.5%). 94 patients were initially diagnosed as stage IV, but took curative resection for primary lesion and metastasectomy. The other 36 patients had recurrent disease as distant metastasis after curative surgery, and then took metastasectomy. The Wnt 5 expression showed the tendency of positive perineural invasion (p = 0.065), but there was no correlation between protein expression and other pathological factors. As a prognostic factor for recurrence, Negative MMP expression showed significantly longer time t o recurrence (TTR) than positive group (13mon vs, 10 months, p = 0.010) and VEGFR expression showed a correlation with TTR (15.7 mon for negative vs. 11.1 mon for positive, p = 0.060). There was no correlation between recurrence and pathological findings such as lymphatic, vascular or perineural invasion, and other protein expressions. Conclusion VEGFR and MMP-9 expression showed prognostic significance for recurrence in stage IV or recurrent colorectal cancer after metastasectomy. Unlikely the stage III colorectal cancer, pathological findings such as lymphovascular or perineural invasion did not have association with recurrence. Disclosure All authors have declared no conflicts of interest.