title: Prognostic value of bone marrow micrometastasis in patients with operable esophageal squamous cell carcinoma: a long-term follow-up study.
abstract: BACKGROUND
  Detection of bone marrow micrometastasis (BMM) has been focused on as a prognostic parameter in various malignant neoplasms recently. This study was designed to evaluate the prognostic significance of BMM detection in patients with operable esophageal squamous cell carcinoma (ESCC) after long-term follow-up.
  
  
  METHODS
  In 61 consecutive patients with ESCC who had undergone radical surgical resection, BMM was detected through reverse transcriptase-polymerase chain reaction (RT-PCR). Correlation between BMM detection and prognosis of the 61 patients was analyzed.
  
  
  RESULTS
  BMM was found in 13 patients (21.3%). No significant correlation between BMM detection and tumor, node, metastasis (TNM) stage was found. The median survival time, 5-year overall survival rate, 5-year disease-free survival rate, and 5-year distant disease-free survival rate for cases with positive BMM were 13.0 months, 15.4%, 7.7%, and 34.2%, respectively, compared with that of 66.0 months, 59.7%, 49.1%, and 60.6% for cases with negative BMM (p < 0.05). In multivariate analysis, BMM were found to be an independent factor in the prediction of overall survival (odds ratio [OR] 3.928, p = 0.001), disease-free survival (OR 4.285, p < 0.001), and distant disease-free survival (OR 3.270, p = 0.013).
  
  
  CONCLUSIONS
  BMM is an independent prognostic factor in the prediction of the subsequent development of metastatic disease and disease outcome for operable ESCC patients, and may be a useful adjunct to conventional tumor staging. Further studies are required to evaluate the value of neoadjuvant or adjuvant systemic therapy in ESCC patients with BMM.
authors.affiliation: *State Key Laboratory of Oncology in Southern China; †Department of Thoracic Surgery, Cancer Center, Sun Yat-Sen University, Guangzhou; ‡Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou; §Guangdong Esophageal Cancer Institute, Guangzhou; ‖Departments of Integrative Oncology, Cancer Hospital of Shantou University Medical College; and ¶Cancer Research Centre, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Shao-Bin
authors.initials: SB
authors.lastname: Chen
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Su
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: Ma
authors.forename: Peng
authors.initials: P
authors.lastname: Lin
authors.forename: Jing
authors.initials: J
authors.lastname: Wen
authors.forename: Fei-Xiang
authors.initials: FX
authors.lastname: Wang
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Fu
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000175:diagnosis; D015996:Survival Rate; D013997:Time Factors