Abstract
BackgroundHigh ERCC1 expression is thought to be related with resistance to chemotherapy based on platinum. The aim of this study was to present our institutional observations regarding to the association of ERCC1 and overall survival (OS) of the lung adenocarcinoma patients who received chemotherapy based on platinum.Material/methodsA total of 253 lung adenocarcinoma patients in all TNM stages were retrospectively investigated. The diagnosis was based on small biopsy samples obtained during bronchoscopy. Depending on the TNM stage of the disease and clinical condition, patients received only the chemotherapy based on platinum, or in combination with radiotherapy or surgery. Tissue sample for ERCC1 immunohistochemical analysis was sufficient in 129 patients. Low from high ERCC1 expression was separated by the semi-quantitative H-score median.ResultsHigh ERCC1 expression was found in 47.3% patients, and was correlated with higher TNM (p = 0.021), tumor enlargement (p = 0.002), positive lymph nodes (p = 0.001), positive distant metastasis (p = 0.005), and higher relative risk of death (p < 0.001). Furthermore, significance association was observed for low ERCC1 expression and better performance status (ECOG) (p = 0.023). Longer OS was strongly associated with a low ERCC1 expression, not only in the group of patients in TNM stage I-III, who were treated with combination of chemotherapy with surgery or radiotherapy (p = 0.002), but also in the group of patients in TNM stage IV who received only chemotherapy based on platinum (p < 0.001), compared with the patients in the same TNM stage and high ERCC1 expression.ConclusionsERCC1 expression in lung adenocarcinoma is a useful prognostic marker and moreover, a useful predictive marker in patients receiving chemotherapy based on platinum in all stages of the disease.
Highlights
High excision repair cross-complementation group 1 (ERCC1) expression is thought to be related with resistance to chemotherapy based on platinum
Longer overall survival (OS) was strongly associated with a low ERCC1 expression, in the group of patients in Tumor Nodes Methastasis (TNM) stage I-III, who were treated with combination of chemotherapy with surgery or radiotherapy (p = 0.002), and in the group of patients in TNM stage IV who received only chemotherapy based on platinum (p < 0.001), compared with the patients in the same TNM stage and high ERCC1 expression
ERCC1 expression in lung adenocarcinoma is a useful prognostic marker and a useful predictive marker in patients receiving chemotherapy based on platinum in all stages of the disease
Summary
High ERCC1 expression is thought to be related with resistance to chemotherapy based on platinum. The aim of this study was to present our institutional observations regarding to the association of ERCC1 and overall survival (OS) of the lung adenocarcinoma patients who received chemotherapy based on platinum. Previous retrospective studies and metaanalyses have correlated high ERCC1 expression with poor prognosis and platinum resistance [3, 5, 6], in a contrast to study of Booton et al who did not find any correlation between the ERCC1 status and survival [7]. Sad et al reported that longer survival was associated with low ERCC1 expression in lung adenocarcinoma patients who received chemotherapy based on platinum compared with those with high ERCC1 expression [8]. The same observation was presented in the study of Zhao et al who found out that in advanced NSCLC, low ERCC1 expression indicates better prognosis and improved effectiveness for platinum-based chemotherapy [9]. Lee et al concluded in a prospective ERCC1 trial (ET) that selecting chemotherapy by using a commercially available ERCC1 antibody did not prolong survival [10]
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