Overexpression of HER-2 Protein is a High-Risk Factor for Patients with Surgically-Resected Stage T3 Gastric Adenocarcinoma.

Abstract

Factors associated with tumor recurrence and death in stage T3-gastric adenocarcinoma (GA) after surgical resection remain unclear. In this study, we investigated whether patients with overexpression of epidermal growth factor receptor 2 (HER-2) comprised a high-risk group. The immunohistochemistry data of HER-2 protein expression from 633 surgically-resected T3-GA tissues were collected and then retrospectively analyzed by Chi-square test, Kaplan-Meier curve, and log rank test as well as univariate and multivariate analyses. Patients with HER-2 overexpression had increased recurrence rates and decreased median recurrence free survival times (MRFST) compared to those with low expression of HER-2 (76.3% vs. 65.4%, p = 0.004; and 18 vs. 26 months, p = 0.002, respectively). Conversely, overall survival rates and median overall survival times (MOST) were decreased in these patients (23.3% vs. 35.7%, p = 0.001 and 26 vs. 36 months, p = 0.001, respectively). HER-2 overexpression, lymph node metastasis (pN1-pN3), distant metastasis, and R1 resection margin were identified as independent prognostic factors for shorter MRFST and MOST in patients with surgically-resected T3-GA. Overexpression of HER-2 is a simple and reliable predictor for increased recurrence and poorer survival in patients with T3-GA following surgical resection. As such, these patients may benefit from trastuzumabbased therapy.