RT Journal Article
T1 Preoperative chemoradiotherapy in rectal cancer induces changes in the expression of nuclear β-catenin: prognostic significance.
A1 Gómez-Millán, Jaime
A1 Pérez, Lydia
A1 Aroca, Inés
A1 Delgado, Maria del Mar
A1 Luque, Vanessa de
A1 Román, Alicia
A1 Torres, Esperanza
A1 Ramos, Soraya
A1 Pérez, Sofia
A1 Bayo, Eloísa
A1 Medina, José Antonio
K1 Locally advanced rectal cancer
K1 Radiotherapy
K1 Chemotherapy
K1 β-catenin
K1 Recurrencia Local de Neoplasia
K1 Neoplasias del Recto
K1 Quimioradioterapia
K1 Cuidados Preoperatorios
AB BACKGROUNDPreoperative chemoradiotherapy (CRT) is the cornerstone of treatment for locally advanced rectal cancer (LARC). Although high local control is achieved, overall rates of distant control remain suboptimal. Colorectal carcinogenesis is associated with critical alterations of the Wnt/β-catenin pathway involved in proliferation and survival. The aim of this study was to assess whether CRT induces changes in the expression of β-catenin/E-cadherin, and to determine whether these changes are associated with survival.METHODSThe Immunohistochemical expression of nuclear β-catenin and membranous E-cadherin was prospectively analysed in tumour blocks from 98 stage II/III rectal cancer patients treated with preoperative CRT. Tumour samples were collected before and after CRT treatment. All patients were treated with pelvic RT (46-50 Gy in 2 Gy fractions) and 5-fluorouracil (5FU) intravenous infusion (225 mg/m2) or capecitabine (825 mg/m2) during RT treatment, followed by total mesorectal excision (TME). Disease-free survival (DFS) was analysed using the Kaplan-Meier method and a multivariate Cox regression model was employed for the Multivariate analysis.RESULTSCRT induced significant changes in the expression of nuclear β-catenin (49% of patients presented an increased expression after CRT, 17% a decreased expression and 34% no changes; p = 0.001). After a median follow-up of 25 months, patients that overexpressed nuclear β-catenin after CRT showed poor survival compared with patients that experienced a decrease in nuclear β-catenin expression (3-year DFS 92% vs. 43%, HR 0.17; 95% CI 0.03 to 0.8; p = 0.02). In the multivariate analysis for DFS, increased nuclear β-catenin expression after CRT almost reached the cut-off for significance (p = 0.06).CONCLUSIONSIn our study, preoperative CRT for LARC induced significant changes in nuclear β-catenin expression, which had a major impact on survival. Finding a way to decrease CRT resistance would significantly improve LARC patient survival.
PB BioMed Central
YR 2014
FD 2014-03-15
LK http://hdl.handle.net/10668/1589
UL http://hdl.handle.net/10668/1589
LA en
NO Gomez-Millan J, Perez L, Aroca I,  Delgado MM,  Luque V De, Román A, et al. Preoperative chemoradiotherapy in rectal cancer induces changes in the expression of nuclear β-catenin: prognostic significance. BMC Cancer. 2014; 14(1):192
NO Journal Article;
DS RISalud
RD Apr 4, 2025