title: ERCC1 expression and tumor regression predict survival in esophageal squamous cell carcinoma patients receiving combined trimodality therapy.
abstract: OBJECTIVE
  Combined trimodality therapy with neoadjuvant chemoradiation followed by surgery has shown promising results for locally advanced operable esophageal cancer. DNA repair proteins may affect treatment efficacy through repairing DNA damage induced by chemotherapy and radiation therapy. We evaluated the associations of XRCC1, ERCC1 and MGMT expression with histopathologic response and survival in patients with locally advanced operable esophageal squamous cell carcinoma (ESCC) who received neoadjuvant chemoradiation.
  
  
  METHODS
  Paraffin-embedded pre-treatment tissue samples, collected by endoscopic biopsy from patients treated with cisplatin-based neoadjuvant chemoradiation followed by surgery, were immunohistochemically stained for XRCC1, ERCC1 and MGMT expression.
  
  
  RESULTS
  Of the 44 patients, major histopathologic response was noted in 26 (59.1%) patients. 68.8% of patients with ERCC1-negative tumors had major histopathologic response, compared to 53.6% of those who expressed positive ERCC1, though the difference was not statistically significant (P=0.361). The patients with ERCC1-negative tumor presented much better overall survival than those positive for ERCC1 expression (P=0.018). Patients with major histopathologic response had a 3-year survival rate of 96.2% versus those with minor response, with a 3-year survival rate of 41.5% (P=0.000). Multivariate analysis showed that ERCC1 expression and histopathologic response were independent predictive factors of overall survival in patients with locally advanced operable ESCC receiving neoadjuvant chemoradiation.
  
  
  CONCLUSIONS
  Patients with ERCC1-negative tumors show a benefit from neoadjuvant chemoradiation, ERCC1 expression and tumor regression are useful predictive markers in patients with locally advanced operable ESCC receiving neoadjuvant chemoradiation followed by surgery.
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, China; Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ge
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, China; Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, China.
authors.forename: Yufei
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, China. Electronic address: yongshun2007@gmail.com.
authors.forename: Yongshun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, China. Electronic address: syujinming@126.com.
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods; D004268:DNA-Binding Proteins / Q000378:metabolism*; D004720:Endonucleases / Q000378:metabolism*; D004938:Esophageal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D004268:DNA-Binding Proteins; C071447:ERCC1 protein, human; D004720:Endonucleases
keywords: ERCC1; Esophagaeal cancer; Histopathologic response; MGMT; Neoadjuvant chemoradiation; XRCC1