title: Postoperative Radiotherapy Improves Survival in Stage pT2N0M0 Esophageal Squamous Cell Carcinoma with High Risk of Poor Prognosis.
abstract: OBJECTIVE
  Clinically, some patients with stage pT2N0M0 esophageal squamous cell carcinoma (ESCC) might have poor survival outcomes after Ivor-Lewis esophagectomy. We explored whether adjuvant radiotherapy could improve the prognosis for the patients with high risk of poor clinical outcomes.
  
  
  METHODS
  We screened 326 pT2N0M0 ESCC patients who had complete resection with Ivor-Lewis esophagectomy. The expression profile of Ku80 was examined by immunohistochemistry and validated by Western blotting. Patients with high expression of Ku80 were divided randomly into the adjuvant radiotherapy group and control group. Patients with low expression of Ku80 were enrolled into the negative group. The overall survival (OS) and disease-free survival (DFS) was determined by Kaplan-Meier and log-rank analysis.
  
  
  RESULTS
  According to receiver operating characteristics curve analysis of Ku80 expression, 124 patients were enrolled into the negative group, 106 patients into the radiotherapy group, and 106 patients into the control group. Log-rank analysis showed that patients in the control group had worse OS and DFS than those in the negative group (P < 0.001, P < 0.001). There is no difference in OS and DFS of patients between radiotherapy group and negative group (P = 0.166, P = 0.648). Patients in the radiotherapy group had significantly better OS and DFS than those in the control group (P = 0.007, P < 0.001). Multivariate analysis further suggested that adjuvant radiotherapy was an independent prognostic indicator for patients with Ku80 overexpression.
  
  
  CONCLUSIONS
  In stage pT2N0M0 ESCC, Ku80 can be exploited as a predictor to identify patients with high risk of poor prognosis. Adjuvant radiotherapy could significantly improve survival for the patients with Ku80 overexpression.
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China. wz620226@hotmail.com.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Cancer Center, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Pathology, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China.
authors.forename: Xiangyan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shang
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong, People's Republic of China.
authors.forename: Wen Peng
authors.initials: WP
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D015153:Blotting, Western; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor