Abstract
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 language | English |
|---|---|
| Journal | Gynecologic Oncology |
| Volume | 104 |
| Issue number | 1 |
| Pages (from-to) | 139-144 |
| Number of pages | 6 |
| ISSN | 0090-8258 |
| DOIs | |
| Publication status | Published - 01.2007 |
Funding
We thank our colleagues from the Department of Radiotherapy and Institute of Pathology for contributing to this study and for their continuous support. We are very thankful to Clare Burns-Klein for revising the manuscript. This work was supported by the Deutsche Krebshilfe (grant number: 106764) and by the State Saxony-Anhalt (grant number: 3584A and B/1104M).
