title: Expression of epidermal growth factor receptor is an independent prognostic factor for esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The overall survival of patients with esophageal squamous cell carcinoma (ESCC) remains poor. Prognostic predictions in ESCC are usually based on histological assessment of tumor invasion and lymph node metastasis, but a biomarker with better predictive accuracy could be more useful. Because overexpression of epidermal growth factor receptor (EGFR) has been associated with poor prognosis, this study investigated whether EGFR is an independent prognostic factor for overall survival and disease-free survival of ESCC patients.
  
  
  METHODS
  ESCC tissue specimens from 243 patients obtained during surgical resection between 1980 and 1997 were retrieved for immunohistochemical analysis of EGFR expression.
  
  
  RESULTS
  The data showed that EGFR protein was overexpressed in 187 of 243 (77%) ESCC tissues. Elevated expression was associated with higher pathologic tumor stages (P = 0.001), lymph node metastasis (P = 0.002), and higher Union for International Cancer Control (UICC) stage (P <0.0001), as well as poorer disease-free survival and overall survival of ESCC patients (P <0.0001). A multivariate analysis showed that overexpression of EGFR protein was an independent factor for disease-free survival (P = 0.003) and overall survival (P = 0.001) of these patients. Subgroup analysis of patients with stage IIA (UICC 2002) showed that EGFR overexpression was associated with poorer disease-free survival (P = 0.007) and overall survival (P = 0.010) of the patients in univariate analyses.
  
  
  CONCLUSIONS
  The current study demonstrated that EGFR overexpression was an independent prognostic factor for overall survival and disease-free survival of ESCC patients. However, targeting of EGFR activity using gefitinib or erlotinib could be useful for clinical treatment of ESCC patients.
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Wang
authors.forename: Hongxia
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), No,17, Nanli, Panjiayuan, Beijing 100021, People's Republic of China. xiaozefen@sina.com.
authors.forename: Zefen
authors.initials: Z
authors.lastname: Xiao
authors.forename: Wencheng
authors.initials: W
authors.lastname: Zhang
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
authors.forename: Xun
authors.initials: X
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: He
authors.forename: Kelin
authors.initials: K
authors.lastname: Sun
authors.forename: Lvhua
authors.initials: L
authors.lastname: Wang
authors.forename: Ningzhi
authors.initials: N
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D066246:ErbB Receptors / Q000378:metabolism*; D004938:Esophageal Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C512478:EGFR protein, human; D066246:ErbB Receptors