Survivin protein expression and hypoxia in advanced cervical carcinoma of patients treated by radiotherapy

Matthias Bache*, Daniel Holzapfel, Matthias Kappler, Hans Jürgen Holzhausen, Helge Taubert, Jürgen Dunst, Gabriele Hänsgen

*Corresponding author for this work
22 Citations (Scopus)


Background: Survivin is strongly overexpressed in the vast majority of cancers. Initial investigations suggest a role for Survivin in radiation resistance. In this study, we investigate the effect of Survivin expression on clinical outcome and its relationship to tumor oxygenation parameters, expression of Hif-1α and anemia in patients with advanced cervical cancers treated with radiotherapy. Material and methods: Biopsies of 44 patients with cervical cancers (Stage IIB: n = 9; Stage IIIB: n = 31; Stage IVA: n = 4) treated with radiotherapy were assessed by immunochemistry for expression of Survivin. Relation of Survivin to pretreatment tumor oxygenation parameters (HF5, pO2), hemoglobin (hb) level, Hif-1α expression and clinical parameters were investigated. Results: Survivin expression was detected in all tumors of the 44 patients. Seven showed a strong expression and 37 have moderate Survivin expression. Patients whose tumors showed moderate Survivin expression had a 5-year overall survival of 66%. However, only one of the seven patients with strong Survivin expression was alive 45 months after treatment. In a Cox regression analysis, Survivin expression was correlated to poor overall survival (p = 0.02, RR = 3.3). There was no relationship between Survivin expression and pO2 or HF5, but rather an inverse correlation with hemoglobin level (p = 0.04). Furthermore, for six of the seven tumors with a high Survivin expression, Hif-1α was detected. Conclusion: Survivin protein expression is linked with anemia and prognosis in advanced cervical carcinoma of patients treated by radiotherapy.

Original languageEnglish
JournalGynecologic Oncology
Issue number1
Pages (from-to)139-144
Number of pages6
Publication statusPublished - 01.2007


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