International Journal of Colorectal Disease

, Volume 24, Issue 11, pp 1261–1269 | Cite as

Increased spontaneous apoptosis, but not survivin expression, is associated with histomorphologic response to neoadjuvant chemoradiation in rectal cancer

  • Dermot T. McDowell
  • Fraser M. Smith
  • John V. ReynoldsEmail author
  • Stephen G. Maher
  • Collette Adida
  • Paul Crotty
  • Eoin F. Gaffney
  • Donal Hollywood
  • Brian Mehigan
  • Richard B. Stephens
  • M. J. Kennedy
Original Article



Survivin has been shown to be an important mediator of cellular radioresistance in vitro. This study aims to compare survivin expression and apoptosis to histomorphologic responses to neoadjuvant radiochemotherapy (RCT) in rectal cancer.

Materials and methods

Thirty-six pre-treatment biopsies were studied. Survivin mRNA and protein expression plus TUNEL staining for apoptosis was performed. Response to treatment was assessed using a 5-point tumour regression grade.


Survivin expression was not found to be predictive of response to RCT (p = NS). In contrast, spontaneous apoptosis was significantly (p = 0.0051) associated with subsequent response to RCT. However, no association between survivin expression and levels of apoptosis could be identified.


This in vivo study failed to support in vitro studies showing an association between survivin and response to chemotherapy and radiation therapy. These results caution against the translation of the in vitro properties of survivin into a clinical setting.


Survivin Rectal cancer Chemoradiotherapy Tumour regression grade Apoptosis 



This work was supported by a grant from the Health and Research Board, Ireland. We would like to thank Mr. Paul Quinlan, Department of Medical Illustration, Trinity College, Dublin for assistance with figures.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Dermot T. McDowell
    • 1
  • Fraser M. Smith
    • 1
  • John V. Reynolds
    • 1
    Email author
  • Stephen G. Maher
    • 1
  • Collette Adida
    • 2
  • Paul Crotty
    • 3
  • Eoin F. Gaffney
    • 4
  • Donal Hollywood
    • 5
  • Brian Mehigan
    • 1
  • Richard B. Stephens
    • 1
  • M. J. Kennedy
    • 5
  1. 1.Department of Academic SurgerySt James’s HospitalDublinIreland
  2. 2.Department of HistopathologyRotunda HospitalDublinIreland
  3. 3.Department of HistopathologyAdelaide and Meath HospitalDublinIreland
  4. 4.Department of HistopathologySt James’s HospitalDublinIreland
  5. 5.Academic Unit of Clinical and Molecular OncologySt James’s HospitalDublinIreland

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