661P - Prognostic significance of survivin expression in patients with gastric cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Gastric Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Masanori Terashima
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors M. Terashima1, K. Hatakeyama2, Y. Yamakawa3, Y. Miki3, R. Makuuchi3, S. Honda3, T. Tatsubayashi3, M. Tokunaga3, Y. Tanizawa3, E. Bando3, T. Kawamura3, K. Oshima2, T. Mochizuki2
  • 1Division Of Gastric Surgery, Shizuoka Cancer Center, 411-8777 - Nagaizumi-Cho/JP
  • 2Medical Genetics Division, Shizuoka Cancer Center, 4118777 - Nagaizumi-Cho/JP
  • 3Division Of Gastric Surgery, Shizuoka Cancer Center, Nagaizumi-Cho/JP



Detection of circulating tumor cells (CTC) in peripheral blood is thought to be a promising method for predicting tumor recurrence and for monitoring treatment efficacy. However, unlike in breast or lung cancer, little information is available in gastric cancer. Recently, survivin, a member of the inhibitor of apoptosis (IAP) family, had been reported to be associated with tumor progression and prognosis in gastric cancer. In addition, survivin expression in peripheral blood appears to be a promising prognostic marker. In order to evaluate the clinical significance of surviving expression in peripheral blood, we performed real-time RT-PCR analysis using whole blood obtained from healthy volunteers and patients with gastric cancer.


A total of 26 healthy volunteers and 129 patients with gastric cancer treated at our cancer center between Nov. 2009 and March 2014 were enrolled in this study. Peripheral blood samples were collected using PAXgene and RNA was isolated using Boom method. After cDNA synthesis, quantitative real-time PCR targeting survivin gene (BIRC5) was performed and the relative expression level of survivin mRNA was calculated. Correlation between survivin expression and clinicopathologic factors and survival was investigated.


Median survivin mRNA expression level in peripheral blood were 171 (46 to 538) in healthy volunteers and 440 (35 to 4932) in gastric cancer, respectively. There was a significant difference between healthy volunteers and gastric cancer (p < 0.0001). Survivin mRNA level tended to be higher in patients with T4, N3b, and StageIV, however, there was no significant differences. Cut-off level of surviving expression was determined at 540 by ROC analysis. In gastric cancer, survivin was positive in 34 patients (26%). Overall survival and disease-free survival was significantly worse in survivin positive patients (p = 0.0451 and p = 0.0171). In multivariate analysis for disease-free survival, survivin was selected as independent prognostic factor as well as lymph node involvement.


Survivin expression in peripheral blood was significantly higher in gastric cancer. In addition, survivin was selected as an independent prognostic factor. Survivin is considered to be a promising CTC marker in gastric cancer.


All authors have declared no conflicts of interest.