Impact of EGFR expression on colorectal cancer patient prognosis and survival

Spano, J.-P.
Lagorce, C.
Atlan, D.
Milano, G.
Domont, J.
Benamouzig, R.
Attar, A.
Benichou, J.
Martin, A.
Morere, J.-F.
Raphael, M.
Penault-Llorca, F.
Breau, J.-L.
Fagard, R.
Khayat, D.
Wind, P.

¹Département d'Oncologie Médicale, Hôpital Pitié-Salpétrière, Paris, France
²Département d'Anatomopathologie, Hôpital Avicenne, Bobigny, France
³Département de Radiothérapie et Statistique, Hôpital Européen Georges Pompidou, Paris, France
⁴Département d'Oncopharmacologie, Centre Antoine Lacassagne, Nice, France
⁵Département de Gastro-Entérologie, Hôpital Avicenne, Bobigny, France
⁶Département de Chirurgie Viscérale, Hôpital Bobigny, Bobigny, France
⁷Département d'Oncologie Médicale, Bobigny, France
⁸Département d'Hématobiologie, Bobigny, France
⁹Département de Biochimie et de Biologie Moléculaire, Hôpital Avicenne, Bobigny, France
¹⁰Département d'Anatomopathologie, Centre Anticancéreux, Clermont-Ferrand, France

Received 27 February 2004; revised 23 July 2004; accepted 26 July 2004

^*Correspondence to: Dr J.-P. Spano, MD, Hôpital Pitié-Salpetrière, Département d'Oncologie Médicale, 47 Boulevard de l'Hôpital, 75013 Paris, France. Tel: +33-1-42-16-04-52; Fax: +33-1-42-16-04-65; Email: [email protected]

^†These two authors contributed equally to this study

Annals of Oncology 16(1):p 102-108, January 2005.

Background

Epidermal growth factor receptor (EGFR) is overexpressed in many types of cancers, especially colorectal cancer (CRC), and seems to reflect more aggressive histological and clinical behaviors. The aim of this study was to evaluate EGFR immunohistochemical reactivity in CRC biopsies, and to analyze its relationship with various histological and clinical characteristics and survival.

Patients and methods

A composite EGFR score, obtained by multiplying the grade (% positive cells) by the intensity of labeling (0–9) was used to define patients with low or high EGFR expression whose clinicopathological features were then compared. Univariate tests and multivariate Cox proportional hazards model were applied for data analysis.

Results

Tissue sections from 150 CRC patients with a median follow-up of 40 months were examined. Median patient age at diagnosis was 70 years (range 38–89 years). EGFR reactivity was positive for 143 patients (97%) and high for 118 (80%). According to multivariate analysis, EGFR overexpression was significantly associated with tumor stage, with a higher percentage of EGFR overexpression in T3 than T4 (P=0.003) and not with overall survival.

Conclusions

EGFR was overexpressed in this CRC patient population and was significantly associated with TNM (tumor–node–metastasis) stage T3. In the context of a new therapeutic strategy using EGFR-targeted therapies, although EGFR remains a controversial prognostic factor, this expression–stage association may play a crucial role in a decision to initiate an adjuvant treatment.