Expression of the antiapoptosis gene survivin predicts poor prognosis of stage III gastric adenocarcinoma

Objective: This study was designed to determine the level of survivin expression and its clinical significance as a prognostic factor in Stage III gastric adenocarcinoma. Methods: We performed immunohistochemical staining for survivin, p53 and Bax in formalin-fixed, paraffin-embedded blocks from 157 surgically resected Stage III gastric cancer tissues. To determine the association with clinical course, we reviewed the patients' clinical records. Results: Of the 157 gastric cancer tissues, 63 (40.1%) cases showed positive expression for survivin protein. There was no significant association between survivin expression and p53 or Bax. For clinicopathologic parameters, large tumor size was closely related to survivin expression (P < 0.05). The 5-year survival rate of patients with positive survivin expression was significantly lower compared with that for survivin-negative cancer patients (P < 0.05). Survivin and p53 were independent prognostic factors in Stage III gastric cancer. Conclusions: Survivin protein is an important predictive and prognostic parameter of poor outcome in gastric carcinoma.