Abstract
Purpose: To evaluate the prognostic value of matrix metalloproteinase-9 (MMP-9) in patients with extrahepatic bile duct (EHBD) cancer undergoing surgical resection and adjuvant radiotherapy. Methods: Between January 2000 and August 2006, patients who underwent complete resection followed by adjuvant radiotherapy for EHBD cancer were enrolled in this study. The expression of MMP-9 was assessed with immunohistochemical staining. The prognostic values of the MMP-9 expression and other clinicopathologic factors were evaluated in univariate and multivariate analyses. Results: Sixty-six patients were included in this study. All received radiotherapy with a median dose of 40 Gy (range, 40–56), and 61 patients received concomitant fluoropyrimidine chemotherapy. MMP-9 was highly expressed in 33 patients (50.0%). MMP-9 expression was significantly associated with locoregional recurrence-free survival (LRRFS) and overall survival (OS) but not with distant metastasis-free survival (DMFS). The 5-year LRRFS and OS rates were 50.8% versus 86.5% (p =.0281), and 23.3% versus 68.1% (p =.0087) in patients with low and high expression of MMP-9, respectively. Among the clinicopathologic factors, tumor location was associated with DMFS and OS (p =.0292 and.0003, respectively). Nodal stage and histologic differentiation showed significant association with DMFS (p =.0277 and.0060, respectively). Based on multivariate analysis for OS, tumor location was the only significant prognostic factor (p =.0021), while MMP-9 expression showed marginal significance (p =.0633). Conclusion: MMP-9 expression is a useful prognostic factor for predicting LRRFS and OS in patients with EHBD cancer after surgical resection and adjuvant radiotherapy.
Original language | English |
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Pages (from-to) | 638-643 |
Number of pages | 6 |
Journal | European Journal of Surgical Oncology |
Volume | 44 |
Issue number | 5 |
DOIs | |
State | Published - May 2018 |
Bibliographical note
Publisher Copyright:© 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
Keywords
- Adjuvant radiotherapy
- Extrahepatic bile duct cancer
- Matrix metalloproteinase-9
- Prognosis