The strongest prognostic factors in colorectal carcinoma

Of 227 patients with stage B or C colorectal carcinoma operated for “cure,” 132 had a febrile postoperative course. Of the latter, five patients (3.7 per cent) died of sepsis. The five-year actuarial recurrence rate for 227 patients was 53 per cent. When the patients were divided into groups according to stage of disease and postoperative fever, the following was found: Eighty-one low stage patients (B₁+B₂) had a 34 per cent five-year actuarial recurrence rate, and 146 high-stage patients (B₃+C₁+C₂)—a 71 per cent rate (P<0.0005). Fever occurred postoperatively in 46 per cent of low-stage patients and in 65 per cent of high-stage patients (P=0.004). In low-stage patients, the five-year actuarial recurrence rate was 3 per cent in the group with an afebrile postoperative course, and 66 per cent in that with fever (P<0.0005). Similarly, in high-stage patients, the recurrence rate was 24 and 93 per cent, respectively in the group with afebrile and febrile postoperative courses (P?0.0005). Preoperative plasma CEA levels seemed to have no bearing upon prognosis, unless above 20 ng/ml. Eighty-two per cent of patients who had serial postoperative plasma CEA measurements and recurrence of cancer had increasing CEA levels. Thus, postoperative fever lasting two or more days was the most unfavorable prognostic factor, highly significant statistically, whereas stage of disease ranked only second in isolating better prognoses among operated patients from those at higher risks of recurrence.     

The prognostic significance of Jun transcription factors in ovarian cancer

Purpose

The Jun proteins (c-Jun, JunD and JunB) play an important role in the regulation of cell proliferation, apoptosis and angiogenesis. It is well established that these proteins participate in the carcinogenesis and progression in several tumour types. However, little is known about the prognostic significance of Jun proteins in patients with invasive epithelial ovarian carcinoma.

Methods

We analysed fresh-frozen tissues of 161 ovarian cancer patients by using Western blot analysis to investigate protein levels of JunB, JunD, c-Jun and phosphorylated c-Jun (pc-Jun Ser63). The results were correlated with clinicopathologic prognostic parameters and survival data.

Results

A high pc-Jun expression was significantly associated with shorter progression-free survival (14 vs. 16 months, p = 0.017) and overall survival (25 vs. 41 months, p = 0.038). In case of JunD, moderate protein levels were associated with a better prognosis, leading to longer progression-free and overall survival compared to weak or strong JunD expression (PFS in cases with weak/moderate/strong JunD expression: 14 vs. 19.5 vs. 16 months, p = 0.011; OAS: 32 vs. 42 vs. 35.5 months, p = 0.009). Multivariate Cox regression analysis confirmed an independent and significant impact of pc-Jun and JunD on the patient’s prognosis.

Conclusions

Our results show that Jun proteins (pc-Jun and JunD) influence carcinogenesis and tumour progression, suggesting a significant role as prognostic predictors in human ovarian carcinoma.     

Correlation of postoperative survival and angiogenic growth factors in pancreatic carcinoma

BACKGROUND/AIMS: VEGF (vascular endothelial growth factor) and EGF (epidermal growth factor) are promoters of angiogenesis. It was the aim of this study to investigate a possible coexpression of both growth factors in tumor samples of pancreatic cancer patients in relation to survival after resection of the tumor. METHODOLOGY: We investigated the expression of VEGF165 and EGF in tumor specimen from 19 patients that underwent pancreaticoduodenectomy. Growth factor expression was determined using immunohistochemical methods. RESULTS: Coexpression of VEGF165 and EGF was observed in tumor samples of 9 (47%) patients. VEGF165 and EGF expression in the same tumor correlates significantly (P < 0.05, Fisher-test). UICC stage III pancreatic carcinoma patients with VEGF165 negative tumor cells had a significantly better outcome after surgery compared to UICC stage III patients with VEGF165-positive tumor cells (median survival time 19 months vs. 9 months respectively; P < 0.05, Wilcoxon-test). CONCLUSIONS: Antiangiogenic therapy after surgery for pancreatic cancer may be beneficial, especially for UICC III patients.     

Beclin 1和PTEN蛋白在胃癌中的表达及预后价值

目的 探讨Beclin 1和PTEN蛋白在胃癌发生过程中的意义及其对预后的影响.方法 应用组织芯片和免疫组织化学法检测199例胃癌及相应癌旁正常组织中Beclin 1和PTEN蛋白的表达,分析其与胃癌的关系;用Western印迹方法检测15例新鲜胃癌及相应癌旁组织中Beclin1和PTEN蛋白的表达率.所有标本均来自上海长征医院.结果 免疫组织化学法检测提示癌组织中Beelin 1和PTEN蛋白阳性表达率分别为47.2％(94/199)和55.8％(111/199),均低于相应癌旁组织的表达率[94.5％(188/199)和92.5％(184/199),P＜0.01].胃癌组织中Beelin 1和PTEN蛋白的低表达均与性别、分化程度、肿瘤浸润深度、淋巴结转移以及疾病分期有关(P＜0.05).胃癌组织中Beclin 1和PTEN的表达呈正相关(r=0.680,P＜0.01).生存分析表明Beclin 1和PTEN均是判断胃癌患者预后的独立因素.Beclin 1阳性患者的5年生存率为67.0％(63/94),阴性者为33.3％ (35/105);PTEN阳性患者的5年生存率为71.2％ (79/111),阴性者为21.6％(19/88)(P值均＜0.01).Western印迹方法检测结果提示胃癌标本中Beclin 1和PTEN蛋白含量明显低于相应癌旁正常组织(P值均＜0.01).结论 Beclin 1和PTEN的异常表达可能和胃癌的发生发展相关.     

The prognostic value of age for patients with common epithelial ovarian cancer

Summary For 230 patients with common epithelial ovarian cancer, the prognostic impact of age was examined. Statistical analysis was done using proportional hazard models, 3- and 5-year survival rates and median survival of stratified groups, and the Kaplan-Meier mean. Taking the age-adjusted mortality into account, the prognosis of the older patients was significantly worse. This effect depended primarily on early mortality (survival time <2 months). A comparative analysis was made of the prognostic factors age, grade, and stage, taking into account the correlation between factors. This analysis showed that, for our series, age was of lesser prognostic significance than grading, and both of these were of much less prognostic importance than staging.     

The prognostic value of calcitonin immunostaining in medullary carcinoma of the thyroid

This study was undertaken to evaluate the prognostic value of calcitonin (CT) immunostaining in medullary carcinoma of the thyroid (MCT). Primary tumors and metastases from 44 patients with MCT were stained for CT using the immunoperoxidase method. According to the number of cells stained in the primary tumors, the patients were subdivided into 3 groups. Group A included 9 patients with CT-poor tumors (less than 25% of cells stained), group C consisted of 21 patients with CT-rich tumors (greater than 75% of cells stained), and group B included 14 patients with intermediate tumors (25-75% of cells stained). Group A and B patients presented with more advanced disease and had a higher rate of recurrence than group C patients, but the difference was not statistically significant. The number of cells stained correlated well with survival, which was significantly longer for group C than groups B (P = 0.044) and A (P = 0.001). Group B patients survived longer than did those of group A (P = 0.036). The 5-yr survival rates were 52.7%, 93%, and 100% for groups A, B, and C, respectively. Eighty-three percent of patients with multiple endocrine neoplasia IIa had CT-rich tumors, whereas 78.3% of those with sporadic disease had CT-poor ones (P less than 0.001). CT-rich metastases were compatible with prolonged survival even if they were affecting vital organs, whereas CT-poor metastases were virulent and carried a poor prognosis. Therefore, CT immunostaining is recommended for all patients with MCT, as it can predict the course of the disease. It also can be used as a staging procedure and may help the clinician in making a decision regarding the therapeutic approach.     

原发性肝癌患者细胞免疫功能变化及其与转归的关系

目的了解原发性肝癌(肝癌)患者细胞免疫功能变化及与临床转归的关系。方法应用流式细胞术检测22例肝癌患者T淋巴细胞亚群及CD8 T淋巴细胞CD28共刺激分子表达，酶联免疫吸附试验及放射免疫法检测血清白细胞介素-2(IL-2)、转化生长因子β1(TGFβ1)及白细胞介素-6(IL-6)水平，并与慢性乙型肝炎、肝硬化及正常对照比较。结果肝癌患者CD8 CD28-T淋巴细胞较正常增高，CD8 CD28 T淋巴细胞显著降低。肝癌、肝硬化及慢性乙型肝炎患者CD4 T淋巴细胞、CD4 ／CD8 比值、IL-2水平较正常明显降低，CD8 T淋巴细胞、IL-6、TGFβ1水平升高；肝癌患者CD4 T淋巴细胞、CD4 ／CD8 比值、IL-2水平低于慢性乙型肝炎，IL-6、TGFβ1水平高于慢性乙型肝炎及肝硬化患者；血清IL-6及TGFβ1水平与肝癌分期相关。结论肝癌患者存在明显的细胞免疫功能紊乱和抗肿瘤免疫功能低下，观察这些指标的变化对估价肝癌患者的抗肿瘤免疫功能以及预后将有帮助。【     

The radiological prognostic factors of transcatheter arterial chemoembolization to hepatocellular carcinoma

Transcatheter arterial chemoembolization (TACE) is the recommended treatment modality for intermediate stage hepatocellular carcinoma (HCC). The aim of this study was to determine the HCC radiological characteristics associated with prognosis of patients with intermediate stage HCC receiving TACE. Patients with HCC BCLC stage B from January 2005 to December 2009 were collected. According to mRECIST criteria, patients with complete response and partial response were assigned to the objective response (OR) group, while those with stable disease and progressive disease were assigned to the nonobjective response (non-OR) group. Among a total of 128 enrolled patients, there were 66 (51.6%) and 62 (48.4%) patients in the OR group and non-OR group, respectively. The clinical parameters in the two groups were similar, although HCC size was smaller in the OR group. Logistic analysis found combined radiological characteristics including complete lipiodol retention, tumor feeding artery blockage, and no residual tumor blush were significant correlated with achievement of OR (odds ratio 2.46, 95% CI 1.08–5.61, P = .032). However, no radiological characteristics had significant strength to predict overall survival. Patients with OR after TACE had significantly longer survival time than those with non-OR. Combined characteristics of complete lipiodol retention, tumor feeding artery blockage, and no residual tumor blush had a positive impact on OR in TACE. In patients receiving TACE, those who achieved OR had a better overall survival.     

Treatment and prognostic factors in patients with hepatocellular carcinoma.

INTRODUCTION: Hepatocellular carcinoma is a leading cause of death from cancer worldwide. Survival of patients depends on tumor extension and liver function, but yet there is no consensual prognostic model. AIMS: To evaluate the influence on survival of pretreatment parameters (clinico-laboratorial, liver function, tumor extension, Okuda and Cancer of the Liver Italian program (CLIP) staging) and treatment modalities. METHODS: We retrospectively analyzed 207 patients, diagnosed between 1993 and 2003. The initial treatment was: surgery--six patients; radiofrequency ablation--21; percutaneous ethanol injection--29; transarterial chemoembolization--49; tamoxifen--49; supportive care alone--53. Factors determining survival were assessed by Kaplan-Meier method and Cox regression models. RESULTS: Median survival was 24 months. In univariate analysis, Child-Pugh classification and Model for end-stage liver disease (MELD) score, portal vein thrombosis (PVT), tumor size, number of lesions, Okuda and CLIP scores were all associated with prognosis (P < 0.001). Alpha-fetoprotein levels were not predictive of survival. Independent predictors of survival were ascites, bilirubin, PVT and therapeutic modalities (P < 0.001). In early stage hepatocellular carcinoma (HCC), survival was similar for both percutaneous ablation modalities, either radiofrequency or ethanol injection (P = NS). In advanced HCC, survival was better in patients receiving tamoxifen than supportive care alone (P < 0.001). CONCLUSION: This study reinforces the importance of baseline liver function (Child-Pugh classification and MELD score) in the survival of patients with HCC, although staging systems allowed the stratification of patients in different prognostic groups. Ascites, bilirubin and PVT were independent pretreatment predictors of survival. All treatments influenced the patient's outcome, whether in early or advanced stages.     

Clinicopathological significance and prognostic value of LRP16 expression in colorectal carcinoma

AIM: To explore the expression of leukemia related protein 16 (LRP16) in colorectal carcinoma, and analyze its correlation with clinicopathologic features and prognosis. METHODS: Immunohistochemistry for LRP16 was performed in 201 cases of colorectal carcinoma and 60 cases of distal normal mucosa. Medical records were reviewed and clinicopathological analysis was performed. RESULTS: LRP16 expression was detected in 117 of 201 cases of the colorectal carcinoma and in 21 cases of 60 distal normal mucosa. The ...     

Clinical prognostic factors for ovarian metastasis in women with gastric cancer

BACKGROUND/AIMS: Krukenberg's tumor is considered to be a metastatic carcinoma to the ovary derived from a primary malignancy, usually from the gastrointestinal tract. This retrospective study tries to evaluate the clinicopathologic characteristics of ovarian metastasis in female gastric cancer and to define the prognostic factors. METHODOLOGY: Of 1,890 female patients with gastric cancers, 37 patients with metastatic ovarian carcinomas were analyzed. RESULTS: Patients with ovarian metastasis were younger in age, higher in primary tumor location, and far advanced in depth of invasion and lymph node metastases. Ovarian metastasis was largely related to the peritoneal seeding, which was statistically significant on survival time. A multivariate analysis of prognostic factors indicated that the presence of peritoneal seeding was the only significant independent factor. The young female patients with far advanced gastric cancer were vulnerable to recurrence of ovarian metastasis and were considered to undergo prophylactic oophorectomy with gastrectomy. The prognosis of ovarian metastasis is dismal, because this is frequently associated with the peritoneal disseminations. CONCLUSIONS: It is essential to treat the peritoneal disseminations in order to improve the survival rate of female gastric cancer patients with ovarian metastasis.     

Predictive value of maternal angiogenic factors in second trimester pregnancies with abnormal uterine perfusion

Angiogenic factors like placental growth factor and its antiangiogenic antagonist soluble fms-like tyrosine kinase 1 (sFlt1) are closely related to the pathogenesis of preeclampsia and intrauterine growth restriction. Because it is known that altered maternal sFlt1 and placental growth factor levels are detectable weeks before the onset of these pregnancy complications, it was the aim of the study to investigate the predictive value of these markers in high-risk second trimester pregnancies characterized by abnormal uterine perfusion. This prospective study includes 63 second trimester pregnant women with abnormal uterine perfusion. Twenty five of them developed a later complication (12 with preeclampsia, 11 with intrauterine growth restriction, and 2 with intrauterine death), whereas 38 had a normal course of pregnancy. Pregnancies with adverse pregnancy outcome showed in the second trimester significantly higher sFlt1 (1403.6+/-555 versus 451.8+/-42 pg/mL; P<0.05) and lower placental growth factor (139.6+/-24 versus 184.1+/-21 pg/mL) levels compared with those with normal outcome. These alterations were more pronounced in pregnancies with subsequent preeclampsia compared with intrauterine growth restriction and early onset diseases (delivery <34 weeks) compared with late-onset diseases. The combination of Doppler and sFlt1 increases the sensitivity of Doppler alone for iatrogenic preterm delivery from 64% up to 79% and the specificity from 63% up to 80%. Using both factors, sFlt1 and placental growth factor, early onset preeclampsia can be predicted with 83% sensitivity and 95% specificity. We conclude that the concurrent measurement of uterine perfusion and angiogenic factors allows an efficient prediction of early onset pregnancy complications, particularly preeclampsia.     

Pathologic data of prognostic significance for remission induction in advanced ovarian carcinoma

Summary Sixty-eight patients with advanced ovarian carcinoma were entered into an ongoing phase-II trial for remission induction with cis-platinum (DDP) 80 mg/m² i.v. on day 1 followed by forced saline diuresis, melphalan (L-PAM) 12 mg/m² i.v. on day 2 and hexamethylamine (HMM) 130 mg/m² p.o. x 14 days from days 8–21 in six monthly cycles following operative resection and/or staging. Fifty-one patients were evaluable for response, ten had not completed six courses and could not be assessed, two patients died early (one probably of toxicity), and five patients refused treatment and follow-up. Thirty-Two patients had serous, endometrioid or undifferentiated carcinomas of the ovary. Of these, 11 (35%) achieved a pathologically proven complete remission (CR), five (16%) were NED after second-look (residual disease in ovary or removed omentum with all other biopsies and cytology washings negative), eight (32%) achieved a partial remission (PR), and three (12%) had progressive disease. None of the seven patients with clear-cell carcinoma and none of the three patients with mixed Mullerian tumor of the ovary responded. Six of nine patients with tumors of uncertain origin or proven metastasis to ovary did not respond to treatment. These preliminary results indicate that advanced ovarian carcinomas form a heterogeneous group of recognizable neoplastic diseases with striking variation in response to treatment.Paper presented at the Annual Meeting of the Swiss Society for Oncology, Basel, March 1983     

CD133和VEGF在肝细胞癌表达及其预后预测价值

目的研究肝细胞癌干细胞标记分子CD133与血管内皮生长因子VEGF在肝细胞癌组织中的表达及其预后价值。方法应用免疫组织化学染色方法检测CD133、VEGF在190例肝细胞癌组织中的表达水平,分析其与各项临床病理指标和无瘤生存之间的关系。结果 CD133、VEGF在肝细胞癌组织中的阳性表达率分别为22.1%(42/190)和52.1%(99/190)。CD133的表达水平与乙型肝炎病毒感染、肝细胞癌分化程度、镜下血管侵犯比较,差异有显著统计学意义(P0.05);CD133表达与VEGF表达水平比较,差异有显著统计学意义(P0.001)。生存分析表明,CD133阳性组术后无瘤生存期明显短于CD133阴性组,差异有显著统计学意义(P=0.036)。结论肝细胞癌组织中,CD133高表达与VEGF高表达、肝细胞癌低分化以及镜下血管侵犯密切相关;CD133表达水平与肝细胞癌术后无瘤生存呈负相关,CD133可能通过调节VEGF表达水平影响肿瘤局部新生血管形成从而影响肝细胞癌预后。     

Clinical results and prognostic factors of radiologically node-positive gastric carcinoma

Lymph node metastasis determined by histologic examination is an important prognostic indicator in gastric carcinoma. However, prognostic value of lymph node metastasis detected by computed tomography (CT) is unknown. The aim of this study was to evaluate clinical results and prognostic factors of patients with radiologically node-positive gastric carcinoma. The study included 78 patients with primary gastric carcinoma and lymph node metastasis confirmed by CT. The level of lymph node metastasis was simply graded as follows: level I included perigastric nodes; level II included intermediate nodes along the left gastric, common hepatic, and celiac arteries; and level III included distant nodes along the hepatoduodenal ligament, pancreas, spleen, and abdominal aorta. Sixty patients (79%) had stage IV tumors showing one or more of the following: level III lymph node metastasis in 37, pancreatic invasion in 27, peritoneal dissemination in 23, and liver metastasis in 19. Overall 1- and 5-year survival rates were 29% and 6%, respectively, and the 1-year survival rate was significantly influenced by the level of lymph node metastasis on CT (55% for level I, 27% for level II, 7% for level III, P < 0.01). In patients with gastrectomy, prognostic factors were tumor size (<10 cm versus >10 cm, P < 0.01), gross type (localized versus infiltrative, P < 0.01), histologic type (well differentiated versus poorly differentiated, P < 0.01), and curability of the disease (curative versus noncurative, P < 0.01). Our study indicates that prognosis of patients with radiologically node-positive gastric carcinoma is poor because of high frequency of extensive tumor spreads. Patients having only positive level I nodes on CT are candidates for curative gastrectomy, which may offer long-term survival.     

Matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases and angiogenic cytokines in peripheral blood of patients with thyroid cancer.

Stimulation of growth of endothelial cells from preexisting blood vessels, i.e., angiogenesis, is one of the essential elements necessary to create a permissive environment in which a tumor can grow. During angiogenesis, the matrix metalloproteinase (MMP) family of tissue enzymes contributes to normal (embriogenesis or wound repair) and pathologic tissue remodeling (chronic inflammation and tumor genesis). The proposed pathogenic roles of MMPs in cancer are tissue breakdown and remodeling during invasive tumor growth and tumor angiogenesis. Tissue inhibitors of metalloproteinases (TIMPs) form a complex with MMPs, which in turn inhibits active MMPs. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are unique among mediators of angiogenesis with synergistic effect, and both can also be secreted by thyroid cancer cells. The goal of the study was to evaluate the plasma blood concentration of VEGF, bFGF, MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, TIMP-1, and TIMP-2 in patients with cancer and in normal subjects. Twenty-two patients with thyroid cancers (papillary cancer, 11; partly papillary and partly follicular cancer, 3; anaplastic cancer, 5; medullary cancer, 3) and 16 healthy subjects (controls) were included in the study. VEGF, bFGF MMPs, and TIMPs were evaluated by enzyme-linked immunosorbent assay (ELISA). In patients with thyroid cancer, normal VEGF concentrations (74.29 +/- 13.38 vs. 84.85 +/- 21.71 pg/mL; p > 0.05) and increased bFGF (29.52 +/- 4.99 vs. 6.05 +/- 1.43 pg/mL; p < 0.001), MMP-2 (605.95 +/- 81.83 vs. 148.75 +/- 43.53 ng/mL; p < 0.001), TIMP-2 (114.19 +/- 6.62 vs. 60.75 +/- 9.18 ng/mL; p < 0.001), as well as lower MMP-1 (0.70 +/- 0.42 vs. 3.87 +/- 0.53; p < 0.001) levels have been noted. Increased plasma levels of MMP-3 and MMP-9 were also found in patients with medullary carcinoma. In conclusion, predominance of MMP-2 over TIMP-2 and TIMP-1 over MMP-1 as well as increased concentration of bFGF in peripheral blood are common features in patients with thyroid cancer.     

Clinicopathologic and prognostic significance of matrix metalloproteinases in rectal cancer

Background and aims

The aim of this study was to determine the prognostic role of matrix metalloproteinases in rectal cancer.

Materials and methods

Formalin-fixed and paraffin-embedded tissue sections of 94 rectal carcinomas were used for the immunohistochemical analysis of matrix metalloproteinases (MMP)-2, MMP-7, MT1-MMP, and tissue inhibitor of metalloproteinases (TIMP)-2. Inclusion criteria were sporadic rectal adenocarcinoma resected curatively (including total mesorectal excision), adjuvant radiochemotherapy in UICC stages II and III, and complete intra-institutional follow-up. Results of immunohistochemistry were correlated with clinical and histopathologic data from the prospective rectal cancer registry and prognosis. End points of the prognostic analysis were tumor progression caused by local and/or distant recurrence and 5-year survival (disease-free and overall). To assess prognostic significance, statistics included univariate and multivariate analysis (p<0.05 statistically significant).

Results

Of the 94 rectal carcinomas, 35% (33/94) showed an epithelial MMP-2 expression, 77% (72/94) were MMP-2 positive in the stroma. Fifty-four percent (51/94) were MMP-7 positive, and 47% (46/94) were positive for both MT1-MMP and TIMP-2. The stromal MMP-2 staining pattern was correlated with the depth of invasion (pT status, p=0.006) with MMP-7 (p=0.016) and TIMP-2 expression (p=0.036). Positive expression of MMP-2 in tumor epithelium was correlated with MMP-7 (p=0.027), MT1-MMP (p=0.036), and TIMP-2 expression (p<0.0001). A positive staining pattern of MMP-7 was significantly correlated with depth of invasion and TIMP-2 (p<0.01). The positive staining pattern of MT1-MMP was correlated with epithelial MMP-2 (p=0.036), MMP-7 (p=0.004), and TIMP-2 expression (p=0.002). TIMP-2 immunoreactivity correlated with depth of invasion (p=0.013), epithelial MMP-2 (p<0.001), stromal MMP-2 (p=0.036), MMP-7 (p<0.001), and MT1-MMP (p=0.002). Neither pattern correlated with age, gender, tumor stage (UICC), grading, preoperative serum carcinoembryonic antigen (CEA) level, or nodal status (p>0.05). Within a mean follow-up of 46 months, tumor progression, caused by either local recurrence or distant metastasis, occurred in 14 patients (15.4%). There was no significant association between the MMP expression and the incidence of local and/or distant recurrence. In terms of survival, preoperative CEA level (disease-free 5-year survival 46% with increased CEA vs 70% with normal CEA, p=0.01; overall 5-year survival 43 vs 74%, p<0.01) and UICC stage were the only factors to be significantly related to 5-year survival by univariate analysis, whereas the metalloproteinases failed to show a significant association. In multivariate analysis, CEA and UICC stage were not identified as independent factors predictive of survival.

Conclusion

MMP-2, MMP-7, MT1-MMP, and TIMP-2 do not appear to be significant predictors of prognosis in a homogenous collective of curatively resected rectal adenocarcinomas.