MKK4 status predicts survival after resection of gastric adenocarcinoma.

Authors

• Steven C Cunningham
• Farin Kamangar
• Min P Kim
• Sommer Hammoud
• Raqeeb Haque
• Christine Iacobuzio-Donahue
• Raheela Ashfaq
• Scott E Kern
• Anirban Maitra
• Richard E Heitmiller
• Michael A Choti
• Keith D Lillemoe
• John L Cameron
• Charles J Yeo
• Elizabeth Montgomery
• Richard D Schulick

Publication/Presentation Date

11-1-2006

Abstract

HYPOTHESIS: Lack of expression of the tumor-suppressor gene MKK4 is significantly correlated with poor survival after resection of gastric adenocarcinoma.

DESIGN: Retrospective review of medical records after construction and immunolabeling of tissue microarrays for clinical correlation.

SETTING: The Johns Hopkins Hospital, Baltimore, Md.

PATIENTS: Patients operated on because of gastric adenocarcinoma between 1983 and 1995. Main Outcome Measure Long-term survival and MKK4 status.

RESULTS: Primary tumors (N = 124) were scored as 0 (no labeling), 1+ (weak labeling), or 2+ (strong labeling) in 9 (7%), 80 (65%), and 35 (28%) patients, and 5-year survival in these patients was 0%, 21%, and 28%, respectively. Given the small size (7%) of the MKK4-negative group (as expected, given the 5%-10% incidence of genetic loss in carcinomas), a Cox proportional hazards analysis was performed, adjusting for age, sex, and tumor stage. This multivariate analysis revealed a 5-fold increased risk of death (P< .001) in patients whose primary tumors were MKK4-negative. Furthermore, the addition of MKK4 status significantly improved the Cox model, changing log likelihood from -1410 to -369, confirming that MKK4 status was truly the effector of the survival difference and not a bystander.

CONCLUSIONS: The lack of expression of the tumor-suppressor gene MKK4 in resected gastric adenocarcinoma is robustly associated with poor survival. This finding may provide a useful prognostic tool in patients with gastric adenocarcinoma.

Volume

141

Issue

11

First Page

1095

Last Page

1099

ISSN

0004-0010

Published In/Presented At

Cunningham, S. C., Kamangar, F., Kim, M. P., Hammoud, S., Haque, R., Iacobuzio-Donahue, C., Ashfaq, R., Kern, S. E., Maitra, A., Heitmiller, R. E., Choti, M. A., Lillemoe, K. D., Cameron, J. L., Yeo, C. J., Montgomery, E., & Schulick, R. D. (2006). MKK4 status predicts survival after resection of gastric adenocarcinoma. Archives of surgery (Chicago, Ill. : 1960), 141(11), 1095–1100. https://doi.org/10.1001/archsurg.141.11.1095

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

17116802

Department(s)

Administration and Leadership

Document Type

Article