Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2022; 14(10): 2048-2060
Published online Oct 15, 2022. doi: 10.4251/wjgo.v14.i10.2048
Long-term follow-up of HER2 overexpression in patients with rectal cancer after preoperative radiotherapy: A prospective cohort study
Nan Chen, Chang-Long Li, Yi-Fan Peng, Yun-Feng Yao
Nan Chen, Chang-Long Li, Yi-Fan Peng, Yun-Feng Yao, Department of Gastrointestinal Surgery, Ward III, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Chen N and Li CL contributed equally to this paper; Chen N and Li CL drafted the manuscript; Chen N, Peng YF and Yao YF designed this study.
Supported by Beijing Municipal Administration of Hospitals Incubating Program, No. PZ2020027; and Beijing Talent Incubating Funding, No. 2019-4.
Institutional review board statement: The study was reviewed and approved by the Beijing Cancer Hospital Institutional Review Board (approval No. 2015KT33).
Clinical trial registration statement: This study is registered at Clinical trial registry of Beijing Cancer Hospital. The registration identification number is 2015KT33.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nan Chen, MD, PhD, Associate Professor, Department of Gastrointestinal Surgery, Ward III, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. chennanpku@126.com
Received: March 1, 2022
Peer-review started: March 1, 2022
First decision: April 19, 2022
Revised: May 17, 2022
Accepted: August 24, 2022
Article in press: August 24, 2022
Published online: October 15, 2022
Processing time: 227 Days and 2.6 Hours
ARTICLE HIGHLIGHTS
Research background

Predictive factors for long-term survival in locally advanced rectal cancer remained controversial. The roles of HER2 over-expression was still under discussion.

Research motivation

The effects of HER2 over-expression on the long-term survival was investigated in this prospective cohort study.

Research objectives

The associations between clinico-pathological factors and long-term survival were evaluated.

Research methods

Categorical variables were assessed using the Chi square (2 × 2) or Fisher's exact test (2 × C), when applicable. Multivariate analysis was performed using a binary logistic regression model (forward: LR). Survival analysis was performed by the Kaplan-Meier method, and the differences between groups were verified by log-rank test.

Research results

The immunohistochemical results showed that HER2 over-expression was detected in 16.6% (25/151) of the tissue samples. HER2 positivity was associated with the pre-treatment N(+) stage (Pre-N) (P = 0.040) and the distant metastasis (P = 0.002). There were significant differences between HER2 positive group and HER2 negative group with respect to both disease-free survival (DFS) [hazard ratio: 1.69 (95% confidence interval: 0.91-3.14); P = 0.048] and overall survival (OS) [1.95 (1.05-3.63); P = 0.0077].

Research conclusions

A considerable part of rectal cancer patients showed HER2 overexpression. HER2 overexpression plays an important role in rectal cancer, which may promote the aggressiveness of rectal cancer, and it may be a potential prognostic biological predictor. For those rectal cancer patients receiving preoperative neoadjuvant radiotherapy, HER2 overexpression predicts lymph node metastasis and distant metastasis, and it is associated with worse long-term DFS and long-term OS.

Research perspectives

For rectal cancer patients, with HER2 over-expression, conventional treatment combined with targeted therapy might be of help.