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Prognostic significance of p53 mutations in colon cancer at the population level
Author(s) -
Samowitz Wade S.,
Curtin Karen,
Ma Kheni,
Edwards Sandra,
Schaffer Donna,
Leppert Mark F.,
Slattery Martha L.
Publication year - 2002
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.10405
Subject(s) - missense mutation , colorectal cancer , mutation , single strand conformation polymorphism , univariate analysis , medicine , biology , population , exon , oncology , cancer , cancer research , pathology , genetics , multivariate analysis , gene , environmental health
Some studies have reported that p53 mutations or certain types of p53 mutation are associated with poor prognosis in colon cancer, while other studies have failed to show such a relationship. None of these previous studies was population‐based. We therefore evaluated the prognostic significance of p53 mutations in a large, population‐based study of 1,464 individuals with colon cancer from Utah and California. Mutations in exons 5–8 were detected by SSCP analysis, followed by sequencing of aberrant bands. p53 mutations were identified in colon cancers from 665 of 1,464 (45.4%) individuals. p53 mutations were significantly more common in distal tumors ( p < 0.01), tumors of relatively high stage ( p = 0.04), tumors without MSI ( p < 0.01) and tumors without Ki‐ras mutations ( p < 0.01). In a univariate analysis, tumors with p53 mutations were associated with a significantly worse 5‐year survival than those with wild‐type p53 (53.4% vs. 58.8%, p = 0.04); significantly worse prognosis also was seen with missense mutations, transitions, transversions, mutations affecting the structure of the p53 molecule, mutations within the β‐sandwich motif and mutations in proximal tumors. In multivariate analyses, however, the only significant predictors of poor prognosis were G245 hot spot mutations (HRR = 2.16, 95% CI 1.06–4.40) and p53 mutations in proximal tumors (HRR = 1.34, 95% CI 1.07–1.63). We conclude that overall p53 mutational status is not an independent predictor of poor prognosis in colon cancer. However, specific classes of mutations, namely, the G245 hot spot mutation and mutations in proximal tumors, are related to significantly worse survival even after adjusting for age and stage. © 2002 Wiley‐Liss, Inc.