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0354). Conclusions: ctDNA was detected in the great majority of patients with mCRC. cfDNA and ctDNA are promising markers of prognosis. Early changes in ctDNA levels may be a useful marker of tumour response. Acknowledgement: Funded by Victorian Cancer Agency. P. Y. Yip1,2,3, W. Cooper4,5, M. Kohonen-Corish2,5,6, B. Lin7, B. McCaughan3,8, M. Boyer1,3, J. Kench2,3,4, L. Horvath1,2,3 1Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia, 2The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, Australia, 3Sydney Medical School, University of Sydney, Sydney, Australia, 4Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia, 5School of Medicine, University of Western Sydney, Sydney, Australia, 6St Vincent's Clinical School, University of New South Wales, Sydney, Australia, 7Department of Anatomical Pathology, [http://www.selleckchem.com/products/obeticholic-acid.html FXR agonist] Concord Hospital, Sydney, Australia, 8Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia Background: The 5-year survival for stage IB non-small cell lung cancer (NSCLC) is only 55%, but the benefit of adjuvant chemotherapy in this setting remains equivocal. Numerous prognostic markers have been examined, but none to date have moved into clinical practice. There is an urgent need to identify novel molecular markers that can select high risk patients, who may potentially benefit from adjuvant chemotherapy. Methods: We identified 471 consecutive patients with stage IB primary NSCLC according to the American Joint Commission on Cancer, (AJCC) 6th edition tumour-node-metastasis staging system, who underwent surgical resection between [http://www.selleckchem.com/products/Adriamycin.html Doxorubicin mouse] 1990 and 2008. Patients who received neoadjuvant or adjuvant treatments were excluded. Pathology reports were reviewed and pathologic characteristics were extracted. Expression of phosphorylated Akt (pAkt) in both cytoplasmic and nuclear locations was assessed by immunohistochemistry, and clinicopathologic [http://en.wikipedia.org/wiki/FARP1 FARP1] factors were analysed against 10-year overall survival using Kaplan-Meier and Cox proportional hazards model. Results: Four hundred and fifty five (96.6%) cancers were adequate for pAkt immunohistochemical analysis. The prevalence of pAkt expression in the cytoplasm and nucleus of the cancers was 60.7% and 43.7% respectively. Patients, whose cancers expressed higher levels of pAkt in the cytoplasm, had a trend towards longer overall survival than those with lower levels of cytoplasmic pAkt (p?=?0.06). Conversely, patients whose cancers expressed higher levels of pAkt in the nucleus had a poorer prognosis than those with lower levels of nuclear pAkt expression (p?=?0.02). Combined low cytoplasmic/high nuclear expression of pAkt was an independent predictor of overall survival [HR?=?2.86 (95% CI: 1.35�C6.04); p?=?0.006] when modelled with age [HR?=?1.05 (95% CI: 1.03�C1.07); p?