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Eur J Surg Oncol. 2018 May;44(5):638-643. doi: 10.1016/j.ejso.2018.01.012. Epub 2018 Jan 12.

High expression of MMP-9 is associated with better prognosis in extrahepatic bile duct cancer patients.

Author information

1
Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
2
Department of Radiation Oncology, Ewha Womans University College of Medicine, Republic of Korea. Electronic address: kyubokim.ro@gmail.com.
3
Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
4
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: ekchie93@snu.ac.kr.
5
Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
6
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

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.

KEYWORDS:

Adjuvant radiotherapy; Extrahepatic bile duct cancer; Matrix metalloproteinase-9; Prognosis

PMID:
29422250
DOI:
10.1016/j.ejso.2018.01.012
[Indexed for MEDLINE]

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