ERCC1 predicting chemoradiation resistance and poor outcome in oesophageal cancer.
We assessed whether expression of excision repair cross-complementation group 1 (ERCC1) and/or thymidylate synthase (TS) can predict clinical outcome after preoperative chemoradiotherapy (CRT) in patients with localised oesophageal cancer. Paraffin-embedded pretreatment tumour specimens collected by endoscopic biopsy from patients treated with preoperative CRT (5-fluorouracil/cisplatin or capecitabine/cisplatin plus radiation) were analysed by immunohistochemical assay. Between March 1993 and June 2005, 129 patients were treated with preoperative CRT followed by surgery; of these, 108 biopsy specimens were available for analysis, and 40% and 35% were positive for ERCC1 and TS, respectively. Patients with ERCC1-negative (p<0.001) or TS-negative (p=0.04) tumours were significantly more likely to achieve pathologic major response. In multivariate analysis, ERCC1 was the only independent variable predicting pathologic response (p<0.001). Patients with ERCC1-negative tumours showed tendencies toward prolonged overall survival (p=0.10) and event free survival (p=0.08). Prospective studies are required to determine the benefit of preoperative CRT in ERCC1-negative tumours.
Kim
Min Kyoung
MK
Division of Oncology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea.
Cho
Kyung-Ja
KJ
Kwon
Gui Young
GY
Park
Seung-Il
SI
Kim
Yong Hee
YH
Kim
Jong Hoon
JH
Song
Ho-Young
HY
Shin
Ji Hoon
JH
Jung
Hwoon Yong
HY
Lee
Gin Hyug
GH
Choi
Kee Don
KD
Kim
Sung-Bae
SB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003131:Combined Modality Therapy; D004268:DNA-Binding Proteins / Q000378:metabolism*; D004720:Endonucleases / Q000378:metabolism*; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis; D013940:Thymidylate Synthase / Q000378:metabolism*
D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D013940:Thymidylate Synthase; C071447:ERCC1 protein, human; D004720:Endonucleases