Che M et al. (2007) Prognostic value of abnormal p53 expression in locally advanced prostate cancer treated with androgen deprivation and radiotherapy: a study based on RTOG 9202. Int J Radiat Oncol Biol Phys 69: 1117–1123

Mutations of the p53 gene and nuclear accumulation of p53 protein are associated with aggressive phenotypes in various human cancers, including prostate cancer. A recent study by Che et al. has evaluated the prognostic value of p53 expression in patients with locally advanced prostate cancer who received radiotherapy together with long-term or short-term androgen deprivation.

This study was based on data from the phase III randomized trial RTOG 9202. Sufficient tumor tissue for p53 analysis was available for 777 patients. In total, 168 (21.6%) patients were considered to have abnormal p53 expression, which was defined as ≥20% of cells with positive p53 nuclear staining. Multivariate analysis adjusting for Gleason score, clinical stage, prostate-specific antigen and treatment showed that abnormal p53 expression was significantly associated with cause-specific mortality (hazard ratio [HR] 1.89; P = 0.014) and distant metastasis (HR 1.72; P = 0.013), but not with overall mortality. In patients who received short-term androgen deprivation and radiotherapy, abnormal p53 expression significantly correlated with cause-specific mortality (HR 2.43; P = 0.0044). Notably, in the subgroup of patients with abnormal p53 expression, the treatment regimen comprising long-term androgen deprivation and radiotherapy was significantly correlated with reduced cause-specific mortality (HR 3.81; P = 0.0087).

This study showed that abnormal p53 expression is a strong independent prognostic factor for patients with prostate cancer who undergo short-term androgen deprivation and radiotherapy.