Abstract
Abstract Background: Worldwide almost 700000 patients are diagnosed with colorectal cancer (CRC) each year. Of these patients more than 45% die as a consequence of metastases, of which the majority is located in the liver. Although patient selection for hepatectomy by 18FDG PET has significantly reduced futile surgery (Ruers, J Nucl Med 2009), 70% of all operated patients still die of metastases within 5 years after hepatic resection. To improve prediction of patient outcome, novel PET tracers with better prognostic value are needed. Matrix metalloproteinases, frequently associated with reduced survival in several types of cancer, might serve as prognostic biomarkers that can be used in PET imaging. Aim: To investigate the prognostic value of MMP9 expression in colon cancer liver metastases. Methods: Formalin-fixed paraffin-embedded colon cancer liver metastases, collected from 85 patients having had curative hepatectomy between 1990 and 2009, were incorporated into tissue microarrays (TMAs). MMP9 expression in both epithelial and stromal cells was assessed by immunohistochemistry and expression was correlated to patient survival data. Survival analysis was performed using a log rank test. Results: Mean age of the colon cancer patients (62.1% males, 37.9% females) was 62.0 (standard deviation 10.5). Chemotherapy was received by 45.9% (15.3% neoadjuvant, 14.1% adjuvant, 16.5% palliative) and radiofrequency ablation (RFA) was performed in 10.8%. Median overall survival was 35.0 months (standard deviation 5.7). High expression of MMP9 by epithelial colon cancer cells within the liver metastases was associated with increased survival rates (p=0.007 for disease-free survival and p=0.056 for overall survival). MMP9 expression in stromal cells was not associated with patient survival. Discussion and conclusion: Our results suggest that elevated levels of MMP9 in metastatic epithelial colon cancer cells are indicative of a good prognosis. Whether MMP9 qualifies as a target with prognostic relevance for imaging of lesions in patients with metastatic colorectal cancer remains to be determined. This research was supported by the Center for Translational Molecular Medicine (DeCoDe project). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5217. doi:10.1158/1538-7445.AM2011-5217
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