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The prognostic relevance of tumor hypoxia markers in resected carcinoma of the gallbladder.
[carcinoma of the gallbladder]
Intratumoral
hypoxia
has
been
suggested
to
drive
more
aggressive
tumor
behavior
.
Our
aim
was
to
define
whether
markers
of
tumor
hypoxia
are
predictors
of
outcome
in
patients
with
gallbladder
carcinoma
.
From
1996
to
2006
,
34
patients
underwent
resection
for
gallbladder
carcinoma
.
The
median
follow-up
was
12
.
6
months
.
Immunohistochemical
stains
for
VEGF
,
HIF
1
α
,
GLUT
1
,
GLUT
3
,
CA
9
and
EGFR
were
performed
on
archival
tissue
.
Immunohistochemical
results
were
correlated
with
clinical
and
histopathological
parameters
.
Cumulative
overall
survival
(
OS
)
rates
were
estimated
using
the
Kaplan-
Meier
method
.
Multivariable
Cox
regression
models
were
used
to
identify
predictors
of
OS
.
T
he
median
OS
was
11
.
9
(
IQR
:
3
.
4
-
22
.
0
)
months
.
Ubiquitous
VEGF
staining
was
observed
in
all
gallbladder
carcinomas
.
High
(
>
50
%
of
tumor
cells
)
EGFR
expression
was
associated
with
worse
OS
(
p
0
.
03
)
.
CA
9
expression
was
less
prevalent
in
poorly
differentiated
tumors
(
p
0
.
02
)
.
GLUT
3
,
GLUT
1
and
HIF
1
α
expression
were
not
associated
with
survival
,
but
did
correlate
with
the
presence
of
lymph
node
metastasis
(
p
0
.
02
)
,
tumor
differentiation
(
p
0
.
04
)
and
tumor
stage
(
p
0
.
03
)
respectively
.
High
EGFR
expression
,
TNM
stage
and
preoperative
serum
CA
1
9
.
9
were
retained
as
independent
predictors
of
OS
in
multivariable
analysis
.
In
gallbladder
cancer
high
expression
of
EGFR
is
an
independent
predictor
of
survival
.
