Overexpression of cyclooxygenase-2 is associated with a poor prognosis in patients with squamous cell carcinoma of the uterine cervix treated with radiation and concurrent chemotherapy

Yongbae Kim, Eon Kim Gwi, Namhoon Cho, Ryull Pyo Hong, Jung Shim Su, Kyung Chang Sei, Chul Park Hee, Chang-Ok Suh, Kyu Park Tchan, Soo Kim Byung

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Abstract

BACKGROUND. The objective of this study was to determine whether cyclooxygenase-2 (COX-2) overexpression was an indicator of prognosis in patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IIIB uterine cervical carcinoma who underwent radiation and concurrent chemotherapy. METHODS. Seventy-five patients with FIGO Stage IIB squamous cell carcinoma (SCC) of the uterine cervix who were treated with radiotherapy and concurrent chemotherapy between 1991 and 1996 were divided into two groups according to their COX-2 level in an immunohistochemical study: the COX-2 negative group (n = 54 patients) and the COX-2 positive group (n = 21 patients). The clinicopathologic features, patterns of treatment failure, and survival data for patients in the COX-2 positive group were compared with data from the patients in the COX-2 negative group. Univariate and multivariate analyses were performed to determine the prognostic factors that influenced patient survival. RESULTS. In the immunohistochemical study, COX-2 overexpression was observed in approximately 30% of patients with FIGO Stage IIB SCC of the uterine cervix. With delayed regression to the initial treatment, the treatment failure rate of patients in the COX-2 positive group was much higher compared with the treatment failure rate of patients in the COX-2 negative group. The higher incidence of central failure and lymph node failure for patients in the COX-2 positive group was statistically significant (48% for the COX-2 positive group vs. 13% for the COX-2 negative group). However, there was no difference in the incidence of hematogenous metastases between the two groups (5% for the COX-2 positive group vs. 7% for the COX-2 negative group). In addition, increased COX-2 expression in tumor cells also was correlated with a shorter interval to tumor recurrence (median interval to recurrence, 9 months in the COX-2 positive group vs. 26 months in the COX-2 negative group). Compared with patients in the COX-2 negative group, patients in the COX-2 positive group had lower overall actuarial and disease free survival rates (overall 5-year actuarial survival rates: 56% for the COX-2 positive group vs. 94% for the COX-2 negative group; P = 0.003). Univariate and multivariate analyses showed that COX-2 overexpression was an independent prognostic factor that surpassed other well-known clinicopathologic parameters. CONCLUSIONS. COX-2 overexpression can be used as a potent molecular risk factor in patients with FIGO Stage IIB SCC of the uterine cervix who are treated with radiotherapy and concurrent chemotherapy.

Original languageEnglish
Pages (from-to)531-539
Number of pages9
JournalCancer
Volume95
Issue number3
DOIs
Publication statusPublished - 2002 Aug 1

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Cyclooxygenase 2
Cervix Uteri
Squamous Cell Carcinoma
Radiation
Drug Therapy
Gynecology
Obstetrics
Treatment Failure
Radiotherapy
Multivariate Analysis
Survival Rate
Recurrence

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Kim, Yongbae ; Gwi, Eon Kim ; Cho, Namhoon ; Hong, Ryull Pyo ; Su, Jung Shim ; Sei, Kyung Chang ; Hee, Chul Park ; Suh, Chang-Ok ; Tchan, Kyu Park ; Byung, Soo Kim. / Overexpression of cyclooxygenase-2 is associated with a poor prognosis in patients with squamous cell carcinoma of the uterine cervix treated with radiation and concurrent chemotherapy. In: Cancer. 2002 ; Vol. 95, No. 3. pp. 531-539.
@article{04df9259e8d64942b4ec876ad99f8556,
title = "Overexpression of cyclooxygenase-2 is associated with a poor prognosis in patients with squamous cell carcinoma of the uterine cervix treated with radiation and concurrent chemotherapy",
abstract = "BACKGROUND. The objective of this study was to determine whether cyclooxygenase-2 (COX-2) overexpression was an indicator of prognosis in patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IIIB uterine cervical carcinoma who underwent radiation and concurrent chemotherapy. METHODS. Seventy-five patients with FIGO Stage IIB squamous cell carcinoma (SCC) of the uterine cervix who were treated with radiotherapy and concurrent chemotherapy between 1991 and 1996 were divided into two groups according to their COX-2 level in an immunohistochemical study: the COX-2 negative group (n = 54 patients) and the COX-2 positive group (n = 21 patients). The clinicopathologic features, patterns of treatment failure, and survival data for patients in the COX-2 positive group were compared with data from the patients in the COX-2 negative group. Univariate and multivariate analyses were performed to determine the prognostic factors that influenced patient survival. RESULTS. In the immunohistochemical study, COX-2 overexpression was observed in approximately 30{\%} of patients with FIGO Stage IIB SCC of the uterine cervix. With delayed regression to the initial treatment, the treatment failure rate of patients in the COX-2 positive group was much higher compared with the treatment failure rate of patients in the COX-2 negative group. The higher incidence of central failure and lymph node failure for patients in the COX-2 positive group was statistically significant (48{\%} for the COX-2 positive group vs. 13{\%} for the COX-2 negative group). However, there was no difference in the incidence of hematogenous metastases between the two groups (5{\%} for the COX-2 positive group vs. 7{\%} for the COX-2 negative group). In addition, increased COX-2 expression in tumor cells also was correlated with a shorter interval to tumor recurrence (median interval to recurrence, 9 months in the COX-2 positive group vs. 26 months in the COX-2 negative group). Compared with patients in the COX-2 negative group, patients in the COX-2 positive group had lower overall actuarial and disease free survival rates (overall 5-year actuarial survival rates: 56{\%} for the COX-2 positive group vs. 94{\%} for the COX-2 negative group; P = 0.003). Univariate and multivariate analyses showed that COX-2 overexpression was an independent prognostic factor that surpassed other well-known clinicopathologic parameters. CONCLUSIONS. COX-2 overexpression can be used as a potent molecular risk factor in patients with FIGO Stage IIB SCC of the uterine cervix who are treated with radiotherapy and concurrent chemotherapy.",
author = "Yongbae Kim and Gwi, {Eon Kim} and Namhoon Cho and Hong, {Ryull Pyo} and Su, {Jung Shim} and Sei, {Kyung Chang} and Hee, {Chul Park} and Chang-Ok Suh and Tchan, {Kyu Park} and Byung, {Soo Kim}",
year = "2002",
month = "8",
day = "1",
doi = "10.1002/cncr.10684",
language = "English",
volume = "95",
pages = "531--539",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
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}

Overexpression of cyclooxygenase-2 is associated with a poor prognosis in patients with squamous cell carcinoma of the uterine cervix treated with radiation and concurrent chemotherapy. / Kim, Yongbae; Gwi, Eon Kim; Cho, Namhoon; Hong, Ryull Pyo; Su, Jung Shim; Sei, Kyung Chang; Hee, Chul Park; Suh, Chang-Ok; Tchan, Kyu Park; Byung, Soo Kim.

In: Cancer, Vol. 95, No. 3, 01.08.2002, p. 531-539.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Overexpression of cyclooxygenase-2 is associated with a poor prognosis in patients with squamous cell carcinoma of the uterine cervix treated with radiation and concurrent chemotherapy

AU - Kim, Yongbae

AU - Gwi, Eon Kim

AU - Cho, Namhoon

AU - Hong, Ryull Pyo

AU - Su, Jung Shim

AU - Sei, Kyung Chang

AU - Hee, Chul Park

AU - Suh, Chang-Ok

AU - Tchan, Kyu Park

AU - Byung, Soo Kim

PY - 2002/8/1

Y1 - 2002/8/1

N2 - BACKGROUND. The objective of this study was to determine whether cyclooxygenase-2 (COX-2) overexpression was an indicator of prognosis in patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IIIB uterine cervical carcinoma who underwent radiation and concurrent chemotherapy. METHODS. Seventy-five patients with FIGO Stage IIB squamous cell carcinoma (SCC) of the uterine cervix who were treated with radiotherapy and concurrent chemotherapy between 1991 and 1996 were divided into two groups according to their COX-2 level in an immunohistochemical study: the COX-2 negative group (n = 54 patients) and the COX-2 positive group (n = 21 patients). The clinicopathologic features, patterns of treatment failure, and survival data for patients in the COX-2 positive group were compared with data from the patients in the COX-2 negative group. Univariate and multivariate analyses were performed to determine the prognostic factors that influenced patient survival. RESULTS. In the immunohistochemical study, COX-2 overexpression was observed in approximately 30% of patients with FIGO Stage IIB SCC of the uterine cervix. With delayed regression to the initial treatment, the treatment failure rate of patients in the COX-2 positive group was much higher compared with the treatment failure rate of patients in the COX-2 negative group. The higher incidence of central failure and lymph node failure for patients in the COX-2 positive group was statistically significant (48% for the COX-2 positive group vs. 13% for the COX-2 negative group). However, there was no difference in the incidence of hematogenous metastases between the two groups (5% for the COX-2 positive group vs. 7% for the COX-2 negative group). In addition, increased COX-2 expression in tumor cells also was correlated with a shorter interval to tumor recurrence (median interval to recurrence, 9 months in the COX-2 positive group vs. 26 months in the COX-2 negative group). Compared with patients in the COX-2 negative group, patients in the COX-2 positive group had lower overall actuarial and disease free survival rates (overall 5-year actuarial survival rates: 56% for the COX-2 positive group vs. 94% for the COX-2 negative group; P = 0.003). Univariate and multivariate analyses showed that COX-2 overexpression was an independent prognostic factor that surpassed other well-known clinicopathologic parameters. CONCLUSIONS. COX-2 overexpression can be used as a potent molecular risk factor in patients with FIGO Stage IIB SCC of the uterine cervix who are treated with radiotherapy and concurrent chemotherapy.

AB - BACKGROUND. The objective of this study was to determine whether cyclooxygenase-2 (COX-2) overexpression was an indicator of prognosis in patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IIIB uterine cervical carcinoma who underwent radiation and concurrent chemotherapy. METHODS. Seventy-five patients with FIGO Stage IIB squamous cell carcinoma (SCC) of the uterine cervix who were treated with radiotherapy and concurrent chemotherapy between 1991 and 1996 were divided into two groups according to their COX-2 level in an immunohistochemical study: the COX-2 negative group (n = 54 patients) and the COX-2 positive group (n = 21 patients). The clinicopathologic features, patterns of treatment failure, and survival data for patients in the COX-2 positive group were compared with data from the patients in the COX-2 negative group. Univariate and multivariate analyses were performed to determine the prognostic factors that influenced patient survival. RESULTS. In the immunohistochemical study, COX-2 overexpression was observed in approximately 30% of patients with FIGO Stage IIB SCC of the uterine cervix. With delayed regression to the initial treatment, the treatment failure rate of patients in the COX-2 positive group was much higher compared with the treatment failure rate of patients in the COX-2 negative group. The higher incidence of central failure and lymph node failure for patients in the COX-2 positive group was statistically significant (48% for the COX-2 positive group vs. 13% for the COX-2 negative group). However, there was no difference in the incidence of hematogenous metastases between the two groups (5% for the COX-2 positive group vs. 7% for the COX-2 negative group). In addition, increased COX-2 expression in tumor cells also was correlated with a shorter interval to tumor recurrence (median interval to recurrence, 9 months in the COX-2 positive group vs. 26 months in the COX-2 negative group). Compared with patients in the COX-2 negative group, patients in the COX-2 positive group had lower overall actuarial and disease free survival rates (overall 5-year actuarial survival rates: 56% for the COX-2 positive group vs. 94% for the COX-2 negative group; P = 0.003). Univariate and multivariate analyses showed that COX-2 overexpression was an independent prognostic factor that surpassed other well-known clinicopathologic parameters. CONCLUSIONS. COX-2 overexpression can be used as a potent molecular risk factor in patients with FIGO Stage IIB SCC of the uterine cervix who are treated with radiotherapy and concurrent chemotherapy.

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DO - 10.1002/cncr.10684

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