Bcl-2 is significantly overexpressed in localized radio-recurrent prostate carcinoma, compared with localized radio-naive prostate carcinoma

Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):1-6. doi: 10.1016/s0360-3016(02)04468-1.


Purpose: We set out to determine whether patients who underwent prostatectomy for recurrence after external-beam radiotherapy for prostate cancer had a higher incidence of alterations in the apoptotic pathway than did patients who underwent surgery as initial treatment.

Materials and methods: Twenty patients who underwent unsuccessful full-dose external-beam radiotherapy for prostate cancer and subsequently underwent salvage radical surgery (radio-recurrent group), and 20 patients matched for various clinical parameters who underwent only radical prostatectomy for localized or locally advanced prostate cancer (radio-naive group), were studied. Tissue samples were examined for immunoreactivity for p53, p21, Bcl-2, and Ki-67 proteins. Statistically, the two groups were compared using exact logistic regression.

Results: Fifty-five percent of the tumors from patients initially treated with radiotherapy were noted to overexpress Bcl-2; whereas, in the radio-naive group, no patient had Bcl-2 overexpression (p = 0.0004). More patients who underwent salvage radical surgery were found to have a higher mean proliferative index (Ki-67 staining) (39.6%), compared with patients undergoing prostatectomy alone (22.1%), p = 0.0800. No significant difference was noted in immunohistochemical expression of p53 and p21 between the two groups.

Conclusions: Patients undergoing radical prostatectomy after radiotherapy had a significantly higher rate of Bcl-2 overexpression than did patients who underwent surgery as the initial treatment. Alterations in the apoptotic pathway may be important in the development of local recurrence after radiation therapy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / genetics*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / surgery
  • Aged
  • Biomarkers, Tumor / blood
  • Cohort Studies
  • Combined Modality Therapy
  • Cystectomy
  • Gene Expression Regulation, Neoplastic / radiation effects*
  • Genes, bcl-2
  • Genes, p53
  • Humans
  • Ki-67 Antigen / biosynthesis
  • Ki-67 Antigen / genetics
  • Male
  • Middle Aged
  • Mitotic Index
  • Neoplasm Proteins / biosynthesis*
  • Neoplasm Proteins / blood
  • Neoplasm Proteins / genetics
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Recurrence, Local / metabolism
  • Prostate-Specific Antigen / blood
  • Prostatectomy* / methods
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / genetics*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy
  • Prostatic Neoplasms / surgery
  • Proto-Oncogene Proteins c-bcl-2 / biosynthesis*
  • Radiotherapy, Adjuvant*
  • Salvage Therapy
  • Tumor Suppressor Protein p53 / biosynthesis


  • Biomarkers, Tumor
  • Ki-67 Antigen
  • Neoplasm Proteins
  • Proto-Oncogene Proteins c-bcl-2
  • Tumor Suppressor Protein p53
  • Prostate-Specific Antigen