Stratification of resectable XXXX by molecular and pathological risk estimators.

@entity1 @entity2 @entity2220 @entity5
BACKGROUND: Mortality in early stage, resectable @entity2 is sufficiently high to warrant consideration of post-surgical treatment. Novel markers to stratify resectable @entity2 @entity1 may help with the selection of treatment to improve outcome. METHODS: Primary @entity5 tissue from 485 @entity1 , surgically treated for stage I-II @entity2220 , was analysed for the RNA expression of 31 cell cycle progression (CCP) genes by quantitative polymerase chain reaction (PCR). The expression average, the CCP score, was combined with pathological stage into a prognostic score (PS). Cox proportional hazards regression assessed prediction of 5-year @entity2 mortality above clinical variables. The PS threshold was tested for risk discrimination by the Mantel-Cox log-rank test. RESULTS: The CCP score added significant information above clinical markers (all @entity1 , P=0.0029; stage I @entity1 , P=0.013). The prognostic score was a superior predictor of outcome compared to pathological stage alone (PS, P=0.00084; stage, P=0.24). Five-year @entity2 mortality was significantly different between the low-risk (90%, 95% confidence interval (CI) 81-95%), and high-risk groups (65%, 95% CI 57-72%), P=4.2*10(-6)). CONCLUSIONS: The CCP score is an independent prognostic marker in early stage @entity2220 . The prognostic score provides superior risk estimates than stage alone. The threefold higher risk in the high-risk group defines a subset of @entity1 that should consider therapeutic choices to improve outcome.
