Cell proliferation-related markers in colorectal liver metastases: Correlation with patient prognosis

Purpose: We analyzed the relation between phenotypic (DNA ploidy) and functional markers (S-phase cell fraction, p53, and bcl-2 protein expression) and defined their relevance on clinical outcome on a retrospective series of radically resected liver metastases from colorectal cancer. Patients and Methods: Among 104 patients with resectable liver metastases from colorectal cancer, DNA ploidy was determined by flow cytometry, H-3-thymidine labeling index (TLI) by autoradiography, and expression of p53 and bcl-2 by immunohistochemistry. Results: TLI was a significant indicator for relapse at 4 years from radical surgery, DNA ploidy was a suggestive indicator of clinical outcome, and p53 and bcl-2 expression provided no clinical information, By multivariate analysis, cell proliferation rate and Dukes' stage remained independent prognostic parameter, In the most representative subgroup of patients with H-1 liver lesions (86 cases), TLI was always associated with relapse, and DNA ploidy and p53 expression provided discriminant information within slowly proliferating liver lesions, Conclusion: Tumor-cell proliferation of liver lesions should be used with stage of the primary colorectal cancer for a more accurate prognosis in patients submitted to curative hepatic resection, (C) 1997 by American Society of Clinical Oncology.