Prospective evaluation of health-related quality of life in a homogeneous Mediterranean group of colorectal cancer patients.

This study was designed to prospectively evaluate health-related quality of life in a homogeneous Mediterranean group of colorectal cancer patients. Ninety-five colorectal cancer patients were preoperatively assessed and followed-up with by skilled investigators using the Short Form-36 Health Survey questionnaire. Overall, patients showed deterioration in all domains, except for pain, when baseline values were compared with 3 and 6 months postoperatively (P = 0.0001). A significant improvement of all Short Form-36 Health Survey questionnaire domains was noted between 6 and 12 months (P = 0.0001). Scores for general health, pain, emotional well-being, and role limitations due to emotional problems at 1 year were shown better than preoperative (P < 0.001). Improved scores in role limitations due to physical health and emotional problems were found at baseline and at 1 year, when laparoscopic were compared with open resections (P < 0.05). Patients that received chemotherapy proved to be more vulnerable regarding their energy, social functioning, and role limitations at 3 months (P < 0.05), whereas older patients had diminished physical functioning at 3 and 6 and 12 months (P < 0.05) postoperatively. Greek colorectal cancer patients remain fragile up to 6 months after surgery, with significant improvements at 1 year, whereas certain aspects of health-related quality of life at 1 year may be even better than before surgery.

P53 and EGFR expression in colorectal cancer: a reappraisal of 'old' tissue markers in patients with long follow-up.

BACKGROUND: Extensive research into the biology of colorectal cancer has identified a plethora of molecular markers reputed to provide prognostic information. During the last two decades conflicting results have been drawn on the role of the p53 tumour suppressor gene and of the first identified member of the type receptor tyrosine kinase family, EGFR, on colorectal cancer prognosis, p53 Mutational status has been associated with both improved and reduced survival. EGFR has been associated with reduced length of survival, increasing Dukes' stage and lymph node metastases in several reports, but as many studies have reported no association with unfavourable prognostic parameters. The aim of this study was to evaluate the p53 and EGFR expression in patients with an at least 5-year follow-up. PATIENTS AND METHODS: Paraffin-embedded material was retrospectively collected from 164 colorectal adenocarcinoma (50 rectal) patients, who had been operated on between 1994 and 2003. The median follow-up was 5 years (range: 1-14). p53 and EGFR expression were evaluated by immunohistochemistry. RESULTS: Positive p53 immunostaining and EGFR expression was observed in 63.4% and 43.9% of patients, respectively. p53 and EGFR positivity rates were significantly interrelated (p = 0.004). No significant correlation was found with the examined clinicopathological parameters except for advanced T-stage, which demonstrated significant associations with p53 expression (p = 0.004), EGFR expression (p = 0.0001) and p53/EGFR coexpression (p = 0.001). In univariate survival analysis (log rank test), stage (p = 0.0001), lymphovascular invasion (p = 0.005) and perineural infiltration (p = 0.004) were associated with the overall cancer-specific survival, while a trend existed for EGFR (p = 0.06) and p53/EGFR coexpression (p = 0.07). On multivariate analysis, only stage was associated with increased risk of cancer death (Cox regression analysis p = 0.0001, b-coefficient (SE): 1.898 (0.383). CONCLUSION: p53 and EGFR were overexpressed in this colorectal cancer patient population and were significantly associated with advanced T stage. In the context of new therapeutic strategies 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.