Annals of Surgical Oncology

, Volume 13, Issue 6, pp 823–835 | Cite as

Prognostic Significance of Epidermal Growth Factor Receptor Expression in Colon Cancer Patients Undergoing Curative Surgery

  • Gennaro Galizia
  • Eva Lieto
  • Francesca Ferraraccio
  • Ferdinando De Vita
  • Paolo Castellano
  • Michele Orditura
  • Vincenzo Imperatore
  • Anna La Mura
  • Giovanni La Manna
  • Margherita Pinto
  • Giuseppe Catalano
  • Carlo Pignatelli
  • Fortunato Ciardiello



To investigate the role of epidermal growth factor receptor (EGFR) expression as a prognostic marker for prediction of cancer behavior and clinical outcomes in colon cancer patients undergoing potentially curative surgery.


EGFR determination using a commercially available immunohistochemistry kit was performed in tissues from 149 colon cancer patients receiving primary surgical treatment and in 25 normal colon mucosa specimens from noncancer patients. EGFR positivity was correlated in univariate and multivariate analyses with disease recurrence and survival. In addition, p27, p53, and vascular endothelial growth factor expression were assessed by immunohistochemistry in 104 patients and correlated with EGFR tumor expression and clinical outcome.


EGFR expression was detected in approximately one third of colon cancer patients (53 of 149; 35.6%). In 126 curatively treated patients, EGFR expression was correlated with disease recurrence and worse survival in both univariate and multivariate analyses. In a multivariate model for predicting recurrence and survival, Dukes’ staging, p27, and EGFR expression were the only independent covariates. In particular, in Dukes’ A and B patients the 5-year survival probability was 96% for EGFR-negative and high p27 expression cases and was 30.7% for EGFR-positive and low p27 expression cases.


EGFR expression was an independent prognostic indicator of disease recurrence and poor survival in colon cancer patients undergoing curative surgery. In the context of novel therapeutic options such as molecularly targeted therapies, these findings suggest that anti-EGFR drugs could be evaluated in the adjuvant treatment of EGFR-positive colon cancer patients.


Epidermal growth factor receptor p27 protein Colon cancer Adjuvant chemotherapy Targeted therapy 



The authors thank Bert Vogelsteinm MD, of the Howard Hughes Medical Institute and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, for his invaluable collaboration and very constructive discussions and criticisms.


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Copyright information

© The Society of Surgical Oncology, Inc. 2006

Authors and Affiliations

  • Gennaro Galizia
    • 1
  • Eva Lieto
    • 1
  • Francesca Ferraraccio
    • 2
  • Ferdinando De Vita
    • 3
  • Paolo Castellano
    • 1
  • Michele Orditura
    • 3
  • Vincenzo Imperatore
    • 1
  • Anna La Mura
    • 2
  • Giovanni La Manna
    • 1
  • Margherita Pinto
    • 1
  • Giuseppe Catalano
    • 3
  • Carlo Pignatelli
    • 1
  • Fortunato Ciardiello
    • 3
  1. 1.Division of Surgical Oncology, “F. Magrassi and A. Lanzara” Department of Clinical and Experimental Medicine and SurgerySecond University of Naples School of MedicineItaly
  2. 2.Division of Pathology, “F. Magrassi and A. Lanzara” Department of Clinical and Experimental Medicine and SurgerySecond University of Naples School of MedicineItaly
  3. 3.Division of Medical Oncology, “F. Magrassi and A. Lanzara” Department of Clinical and Experimental Medicine and SurgerySecond University of Naples School of MedicineItaly

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