Predictive Value of ERCC1, ERCC2, and XRCC1 Overexpression for Stage III Colorectal Cancer Patients Receiving FOLFOX-4 Adjuvant Chemotherapy

ObjectivesTo determine the correlation between expression of three DNA repair genes and early failure/clinical outcome of stage III colorectal cancer (CRC) patients administrated with FOLFOX-4, including the excision repair cross-complementation group 1 (ERCC1), the excision repair cross-complementing 2 (ERCC2), and X-ray repair cross-complementing protein 1 (XRCC1). Materials and MethodsWe retrospectively analyzed clinicopathological features and ERCC1, ERCC2, XRCC1 expressions by immunohistochemical staining in 180 stage III CRC patients undergoing curative resection and treated with FOLFOX-4 chemotherapy to identify predictors of postoperative early failure. ResultsAmong 180 CRC patients, 44 patients were classified into early failure group, and 136 patients were categorized into non-early failure group. A multivariate logistic regression analysis showed that ERCC1 overexpression (P=0.005), and high postoperative carcinoembryonic antigen (CEA) levels (P=0.001) were independent predictors of early failure. Additionally, ERCC1 overexpression was not only a predictor of early failure but also for disease-free survival (P<0.001) and overall survival (P<0.001). However, no predictive roles of ERCC2 and XRCC1 expression among these analyzed patients. ConclusionsERCC1 overexpression is an important predictor of early failure in patients with stage III CRC administrating FOLFOX-4 adjuvant chemotherapy and this marker may help identify patients who would benefit from intensive follow-up and enhance therapeutic programs. J. Surg. Oncol. 2013; 108:457-464. (c) 2013 Wiley Periodicals, Inc.