Cyclooxygenase-2 expression after preoperative chemoradiotherapy correlates with more frequent esophageal cancer recurrence.
OBJECTIVE
To investigate the relationship between cycloo-xygenase-2 (COX-2), and vascular endothelial growth factor (VEGF), and to determine the clinical significance of this relationship in esophageal cancer patients undergoing chemoradiotherapy (CRT).


METHODS
Immunohistochemical staining was used to evaluate COX-2 and VEGF expression in 40 patients with histologically-confirmed esophageal squamous carcinoma (ESCC) who were undergoing preoperative CRT.


RESULTS
Fourteen out of 40 ESCC patients showed a pathological complete response (CR) after CRT. COX-2 and VEGF protein expressions were observed in the cytoplasm of 17 and 13 tumors, respectively, with null expression in 9 and 13 tumors, respectively. COX-2 expression was strongly correlated with VEGF expression (P<0.05). There were also significant associations between COX-2 expression, tumor recurrence, and lymph-node involvement (P=0.0277 and P=0.0095, respectively). COX-2 expression and VEGF expression had significant prognostic value for disease-free survival (log-rank test; P=0.0073 and P=0.0341, respectively), but not for overall survival, as assessed by univariate analysis.


CONCLUSIONS
Our results suggest that COX-2 expression correlates with VEGF expression and might be a useful prognostic factor for more frequent tumor recurrence in ESCC patients undergoing neoadjuvant CRT. These findings support the use of anti-angiogenic COX-2 inhibitors in the treatment of ESCC.
Yoshikawa
Reigetsu
R
Second Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. yosikr2s@hyo-med.ac.jp
Fujiwara
Yoshinori
Y
Koishi
Kenji
K
Kojima
Syoudou
S
Matsumoto
Tomohiro
T
Yanagi
Hidenori
H
Yamamura
Takehira
T
Hashimoto-Tamaoki
Tomoko
T
Nishigami
Takashi
T
Tsujimura
Tohru
T
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000201:enzymology* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D051546:Cyclooxygenase 2 / Q000235:genetics / Q000378:metabolism*; D004938:Esophageal Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000628:therapy*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism
D042461:Vascular Endothelial Growth Factor A; D051546:Cyclooxygenase 2