Article

ERCC1 expression as a prognostic and predictive factor in patients with non-small cell lung cancer: A meta-analysis

Department of Oncology, Huashan Hospital, Fudan University, Shanghai, China.
Molecular Biology Reports (Impact Factor: 1.96). 02/2012; 39(6):6933-42. DOI: 10.1007/s11033-012-1520-4
Source: PubMed

ABSTRACT It is hypothesized that high expression of the excision repair cross-complementation group 1 (ERCC1) gene might be a positive prognostic factor, but predict decreased sensitivity to platinum-based chemotherapy. Results from the published data are inconsistent. To derive a more precise estimation of the relationship between ERCC1 and the prognosis and predictive response to chemotherapy of non-small cell lung cancer (NSCLC), a meta-analysis was performed. An electronic search of the PubMed and Embase database was performed. Hazard ratio (HR) for overall survival (OS) was pooled in early stage patients received surgery alone to analyze the prognosis of ERCC1 on NSCLC. HRs for OS in patients received surgery plus adjuvant chemotherapy and in patients received palliative chemotherapy and relative risk (RR) for overall response to chemotherapy were aggregated to analyze the prediction of ERCC1 on NSCLC. The pooled HR indicated that high ERCC1 levels were associated with longer survival in early stage patients received surgery alone (HR, 0.69; 95% confidence interval (CI), 0.58-0.83; P = 0.000). There was no difference in survival between high and low ERCC1 levels in patients received surgery plus adjuvant chemotherapy (HR, 1.41; 95% CI, 0.93-2.12; P = 0.106). However, high ERCC1 levels were associated with shorter survival and lower response to chemotherapy in advanced NSCLC patients received palliative chemotherapy (HR, 1.75; 95% CI, 1.39-2.22; P = 0.000; RR, 0.77; 95% CI, 0.64-0.93; P = 0.007; respectively). The meta-analysis indicated that high ERCC1 expression might be a favourable prognostic and a drug resistance predictive factor for NSCLC.

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    PLoS ONE 02/2014; 9(2):e89534. DOI:10.1371/journal.pone.0089534 · 3.23 Impact Factor
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    • "ERCC1 can recognize and remove these adducts and covalent cross-links, thus resistant to platinum agents [12]. A recent meta-analysis indicated that high ERCC1 level was a positive prognostic factor, being associated with shorter survival and lower response to platinum-based chemotherapy in advanced NSCLC patients [23]. Interestingly, we revealed that the SUVmax of ERCC1-positive cases were significantly higher than that of ERCC1-negative cases, there was statistical correlation between SUVmax and ERCC1 level, but failed to detect robust correlationship when the multiple stepwise regression was performed. "
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    BMC Cancer 11/2013; 13(1):546. DOI:10.1186/1471-2407-13-546 · 3.32 Impact Factor
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    • "It is possible that the presence of ERCC1 reflects an inherent biologic characteristic of the tumor. The ERCC1 expression level has recently been reported to be a prognostic factor in the survival of patients with early stage NSCLC [8,12]. Our study evaluated the effect of intratumoral ERCC1 expression on the survival of patients with completely resected p-stage III/N2 NSCLC. "
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    ABSTRACT: Background Pathological stage III/N2 non-small cell lung cancer (NSCLC) is heterogeneous, and the optimal prognostic marker for survival remains unclear in Chinese patients. The aim of the present study was to assess the prognostic value of the clinicopathologic features and excision repair cross-complementing group-1 (ERCC1) in resected p-stage III/N2 NSCLC patients that received cisplatin-based adjuvant chemotherapy. Methods Clinical data concerning 115 patients with histopathologically confirmed stage III/N2 NSCLC who underwent a complete resection were reviewed retrospectively. All patients received cisplatin-based adjuvant chemotherapy. The protein expression levels for ERCC1 were immunohistochemically examined in 115 patients. The relationship between the ERCC1 protein expression level and the clinical outcomes of the patients was then observed. Results The 5-year survival rate and median survival time of patients with pathological stage III/N2 NSCLC after surgery and postoperative chemotherapy was 27.0% and 28.0 months, respectively. Survival of patients with ERCC1 negative tumors was significantly longer than those with ERCC1 positive tumors (p = 0.004). However, it was not entirely clear whether adjuvant chemotherapy with cisplatin-based agents was beneficial for ERCC1-negative patients with p-stage III/N2. A multivariate analysis of survival in patients with stage III/N2 NSCLC showed that surgical procedure (pneumonectomy vs. lobectomy; p = 0.001), number of involved lymph nodes (≤5 vs. >5; p = 0.001) and ERCC1 protein expression (negative vs. positive; p = 0.012) were significant prognostic factors. In addition, the prognosis of patients with skip mediastinal lymph node metastasis showed a tendency for improved survival, but this was no significant (p = 0.432). Conclusions Findings from this retrospective study suggested that the number of involved lymph nodes and the type of pulmonary resection are significant and independent prognosis factors in patients with p-stage III/N2 NSCLC. In addition, it was found that ERCC1 protein expression might play an important role in the prognosis of p-stage III/N2 NSCLC patients treated with cisplatin-based adjuvant chemotherapy.
    Journal of Cardiothoracic Surgery 06/2013; 8(1):149. DOI:10.1186/1749-8090-8-149 · 1.03 Impact Factor
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