Publication:

TP53 overexpression and three-year survival in stage III and IV colorectal cancer: a retrospective cohort study

Background TP53 mutations are among the most common molecular alterations in colorectal cancer (CRC) and are frequently associated with tumor aggressiveness and poor prognosis. This study evaluated the influence of TP53 overexpression on three-year overall survival in patients with stage III and IV CRC.

Methods A retrospective cohort study was conducted on 46 patients with stage III–IV CRC treated at Dr. Moewardi General Hospital, Surakarta, Indonesia, between 2020 and 2023. TP53 expression was assessed using immunohistochemistry and categorized as overexpression or non-overexpression. Survival outcomes were analyzed using Chi-square and Kaplan–Meier methods with log-rank testing.

Results Seventeen patients (36.9%) demonstrated TP53 overexpression, whereas 29 (63.1%) showed non-overexpression. Mortality before three years was significantly higher in the overexpression group (82.4%) than in the non-overexpression group (31.0%). TP53 overexpression was significantly associated with reduced three-year survival (p=0.001; Cramer’s V=0.495). Kaplan–Meier analysis demonstrated significantly shorter survival among patients with TP53 overexpression (log-rank p=0.002). Metastatic status and lymphovascular invasion were also associated with poorer survival.

Conclusions TP53 overexpression is significantly associated with decreased three-year survival in advanced CRC and may serve as a useful prognostic biomarker for risk stratification and treatment planning.