Evaluation of prognostic factors of esophageal squamous cell carcinoma (stage II-III) after concurrent chemoradiotherapy using biopsy specimens.
BACKGROUND
Recently, attention has been directed to concurrent chemoradiotherapy (CRT) for the treatment of squamous cell carcinoma of the esophagus with regard to efficacy, quality of life and functional preservation, and survival periods comparable to those after standard surgical therapy have been reported in responders to CRT. However, there are some non-responders to CRT, and the prediction of the outcome after CRT is an important subject for future studies. In this study, using biopsy specimens obtained before CRT, we evaluated the relationships between biological markers and the outcome after CRT in order to determine the prognostic factors of CRT.


METHODS
The subjects were 51 patients (42 males and nine females: median age 68 years). who were histologically confirmed to have squamous cell carcinoma of the esophagus at stage II or III (UICC). Concurrent CRT consisting of chemotherapy using 5FU and CDDP and radiation therapy (60 Gy) was performed as the initial treatment, and the relationships of overexpression of EGFR, p53, VEGF, PCNA and CyclinD1 were examined immunohistochemically in biopsy specimens collected before treatment. Overall survival was estimated by multivariate analysis.


RESULTS
The percentages of patients overexpressing p53, VEGF, PCNA, CyclinD1, and EGFR were 33, 31, 37, 31 and 29%, respectively. On multivariate analysis, T stage (P = 0.0393) and PCNA (P = 0.0302) were found to be significant prognostic factors.


CONCLUSIONS
PCNA overexpression appears to be a prognostic factor for squamous cell carcinoma of the esophagus after CRT.
Kii
Takayuki
T
Department of Internal Medicine II, Osaka Medical College, Takatsuki, Osaka, Japan. in2058@poh.osaka-med.ac.jp
Takiuchi
Hiroya
H
Kawabe
Shinichiro
S
Gotoh
Masahiro
M
Ohta
Shunsuke
S
Tanaka
Toshimitsu
T
Kuwakado
Shin
S
Nishitani
Hitoshi
H
Katsu
Ken-ichi
K
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D019938:Cyclin D1 / Q000032:analysis; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D066246:ErbB Receptors / Q000032:analysis; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D000970:Antineoplastic Agents; D018809:Proliferating Cell Nuclear Antigen; D016159:Tumor Suppressor Protein p53; D019938:Cyclin D1; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; C512478:EGFR protein, human; D066246:ErbB Receptors; D005472:Fluorouracil