Mitotic activity index, volume corrected mitotic index and human papilloma-virus suggestive morphology are not prognostic factors in carcinoma of the oesophagus.
Radiation treatment, endoscopic dilatations and laser treatment offer an alternative to surgery as palliation in oesophageal cancer, and therefore it is essential to assess the prognostic factors preoperatively in order to select the treatment individually. Mitotic activity index (MAI), volume corrected mitotic index (M/V-index) and histologic evidence for human papillomavirus (HPV) involvement together with other prognostic factors were studied in 61 patients with oesophageal squamous cell carcinomas. No patient was lost from follow-up and 18% of patients were alive at the end of follow-up. Evidence for HPV involvement was found in 11 (18%) of 61 patients, which was significantly (p < 0.001) less than in a previous series of Chinese patients. Histological grade (p = 0.025), lymph node status (p = 0.002), presence of distant metastasis (p = 0.004), surgical resection (p = 0.03) and nuclear pleomorphism (p = 0.04) were significant independent prognostic factors in univariate analysis. In multivariate analysis, the length of the tumour (p = 0.0002) as well as its histological grade (p = 0.0001) significantly predicted the patient survival. Surgical resection was almost included into the model (p = 0.11). On the other hand, MAI, M/V-index or HPV histology did not reach statistical significance as prognostic factors.
Department of Surgery, University Hospital of Kuopio, Finland.
M
M
Hippeläinen
M
M
Eskelinen
P
P
Lipponen
F
F
Chang
K
K
Syrjänen
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D027383:Papillomaviridae; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D014412:Tumor Virus Infections / Q000401:mortality* / Q000473:pathology