High intrinsic apoptosis, but not radiation-induced apoptosis, predicts better survival in rectal carcinoma patients Corrie A. M. Marijnen *AIris D. Nagtegaal †‡ †‡, Adri A. Mulder-Stapel †, Peter I. Schrier *, Cornelis J. H. van de Velde †, J. Han J. M. van Krieken § and Lucy T. C. Peltenburg * Leiden 2300 RC The Netherlands. Tel: +31-71-5261539; Fax: +31-71-5266760 A Reprint requests to: Corrie A. M. Marijnen, M.D., Ph.D., Department of Clinical Oncology, Leiden University Medical Center, K1-P, P.O. Box 9600, [*]Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands[†]Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands[‡]Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands[§]Department of Pathology, University Medical Center St. Radboud, Nijmegen, The Netherlands Abstract Purpose An important feature of malignant tumors is the disturbance in the balance between proliferation and cell death. We evaluated the relevance of intrinsic and radiation-induced apoptosis and proliferation for prognosis in rectal cancer patients. Methods and materials Patients were selected from a study that randomized for preoperative radiotherapy (RT). Apoptosis and proliferation were scored using specific antibodies in immunohistochemistry. The number of positive cells per square millimeter of carcinoma cells was determined in 98 randomly selected tumors, of which 45 had been irradiated. For the survival analyses, a cohort of 104 patients without positive circumferential resection margins was selected. Results In nonirradiated patients, high levels of intrinsic apoptosis correlated with better local control (p = 0.04) and better cancer-specific survival (p = 0.02). RT increased the median amount of apoptosis from 10.8 to 21.5 cells/mm2 (p = 0.004), but this was not predictive for survival. The amount of proliferative cells was not altered after RT and had no influence on prognosis. Conclusion Intrinsic apoptosis correlated with both local control and cancer-specific survival, but proliferation was not predictive for prognosis. However, although RT increased apoptosis, its prognostic value was lost after RT. This is possibly because in rectal cancer, the proliferative status of tumors is always high and the aggressiveness of the tumor is determined by the number of ''spontaneous'' apoptotic tumor cells. Intl J Radiation Oncology, Biology, Physics Volume 57 Issue 2 (1 October 2003) Pages 434-443 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.