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ERCC1 Predicts a Poorer Platinum-based Chemotherapy Outcome but a Better Outcome for Uracil-Tegafur in the Resected Stage I-II NSCLC

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·ùÇѼ®, Xu Xianhua, ±èÈ¿Áø, ÀÌÁ¾¼÷, Àü»óÈÆ, Á¤ÁøÇà,
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·ùÇѼ® ( Ryu Han-Suk ) 
Seoul National University College of Medicine Department of Pathology

 ( Xu Xianhua ) 
Seoul National University College of Medicine Department of Pathology
±èÈ¿Áø ( Kim Hyo-Jin ) 
Seoul National University College of Medicine Department of Pathology
ÀÌÁ¾¼÷ ( Lee Jong-Suk ) 
Seoul National University College of Medicine Department of Thoracic Surgery
Àü»óÈÆ ( Jheon Sang-Hoon ) 
Seoul National University College of Medicine Department of Internal Medicine
Á¤ÁøÇà ( Chung Jin-Haeng ) 
Seoul National University Bundang Hospital Department of Pathology

Abstract


Background : The role of excision repair cross-complementation group 1 (ERCC1) has been controversial in non-small cell lung cancer (NSCLC) patients who received adjuvant chemotherapy with a platinum agent. We investigated ERCC1 expression in stage I-II NSCLC to clarify its signifi-cance for adjuvant chemotherapy.

Methods : The ERCC1 expression profile was evaluated by immunohistochemistry and compared according to adjuvant chemotherapeutic agents in 146 patients who underwent surgical resection for stage I-II NSCLC. The patients were divided into 3 groups; adjuvant chemotherapy with a platinum based agent (18.5%, 27/146); adjuvant chemotherapy with uracil-tegafur (UFT) (40.4%, 59/146); surgery-alone (41.1%, 60/146).

Results : Nuclear ERCC1 expression was detected in 71.9% (105/146) of NSCLC and was significantly associated with a shortened survival period in the group 1 patients who received the platinum based regimen after surgery. The group 2 patients who received UFT showed the longest survival period, followed by the surgery-alone group (overall survival, p=0.049; disease-free survival [DFS], p<0.001).

Conclusions : These results suggest that stage I-II NSCLC patients with ERCC1 expression experience a shorter DFS period with adjuvant chemotherapy with a platinum based regimen and may benefit from adjuvant chemotherapy with UFT, instead of platinum after surgery.

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Carcinoma; non-small-cell lung; ERCC1 protein; human; Chemotherapy; adjuvant

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