@article {KIM6881, author = {JIYOUNG KIM and SOOMIN AHN and KYUBO KIM and MIN SUN CHO and KWANG HO KIM and RYUNG-AH LEE and EUN MI NAM}, title = {Prognostic Significance of Survivin Expression and Combined Analysis with Cancer Stem Cell and Epithelial{\textendash}Mesenchymal Transition-related Markers in Patients with Rectal Cancer Undergoing Preoperative Chemoradiotherapy}, volume = {38}, number = {12}, pages = {6881--6889}, year = {2018}, doi = {10.21873/anticanres.13064}, publisher = {International Institute of Anticancer Research}, abstract = {Aim: To identify the candidate marker predicting treatment response and survival outcome in rectal cancer patients who received preoperative chemoradiotherapy (CRT). Patients and Methods: Between 2000 and 2015, 159 patients with histologically-confirmed rectal adenocarcinoma underwent preoperative CRT followed by surgery. Among them, 70 patients were enrolled and the expression of survivin, cancer stem cell markers (CD44 and CD133) and epithelial{\textendash}mesenchymal transition markers (E-cadherin and TWIST1) in pretreatment biopsy specimens were evaluated by immunohistochemistry. Associations between the expression of markers and clinical outcomes were evaluated. Results: The median follow-up period of all patients was 71 (range=15-203) months. Five-year overall (OS), disease-free (DFS), locoregional recurrence-free (LRRFS) and distant metastasis-free (DMFS) survival were 80.5\%, 60.2\% 90.1\% and 76.5\%, respectively. A significant association between survivin overexpression and worse treatment outcome was shown on univariate analyses for OS, DFS and DMFS (p=0.022, 0.002, and 0.005, respectively). On multivariate analysis, survivin overexpression was an adverse prognosticator for DFS and DMFS (p=0.007 and 0.015, respectively), with a borderline significant trend towards a shorter OS (p=0.069). Four other single biomarkers were not associated with survival outcomes. However, overexpression of both survivin and CD44 was significantly associated with worse OS on multivariate analysis (p=0.003). Conclusion: Survivin combined with CD44 might be a candidate biomarker for the prediction of recurrence and survival in patients who received preoperative CRT for rectal cancer. Further research with a larger population is needed to validate these results.}, issn = {0250-7005}, URL = {https://ar.iiarjournals.org/content/38/12/6881}, eprint = {https://ar.iiarjournals.org/content/38/12/6881.full.pdf}, journal = {Anticancer Research} }