Prognostic significance of TWIST and E-cadherin expression in primary tumor blocks of patients with early-stage melanoma and locally advanced rectal cancer: impact on disease outcome and therapy effectiveness

Aim. To assess the prognostic value of TWIST and E-cadherin expression in primary tumor samples of patients with early-stage cutaneous melanoma and locally advanced rectal cancer. To determine their association with clinicopathological features, risk of progression, and treatment response.

Materials and methods. A retrospective analysis of two patient cohorts was performed. The first cohort included

101 patients with pT1a–1b cutaneous melanoma. The second cohort comprised 75 patients with locally advanced rectal cancer (T2–4N0–2M0) who underwent neoadjuvant chemoradiotherapy. In all cases, immunohistochemical assessment of TWIST and E-cadherin expression in primary tumors was carried out. Associations with disease progression, treatment effectiveness, and histopathological features were analyzed.

Results. In melanoma patients, reduced E-cadherin expression (<80 %) and elevated TWIST expression (>20 %) were significantly associated with 5-year disease progression (p <0.01). In rectal cancer patients, similar expression profiles correlated with poor response to chemoradiotherapy (tumor regression grading: 3–4), low tumor regression grade, and reduced overall and disease-free survival (p <0.05). TWIST and E-cadherin demonstrated independent prognostic significance in both cancer types.

Conclusion. Altered TWIST and E-cadherin expression in primary tumors reflects epithelial – mesenchymal transition activation, associated with aggressive clinical behavior, therapy resistance, and higher risk of disease progression. These markers may be used to refine risk stratification and guide treatment personalization.

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