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Japanese Journal of Clinical Oncology Advance Access published online on August 20, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym077
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© 2007 Foundation for Promotion of Cancer Research

Evaluation of Prognostic Factors of Esophageal Squamous Cell Carcinoma (Stage II–III) After Concurrent Chemoradiotherapy Using Biopsy Specimens

Takayuki Kii, Hiroya Takiuchi, Shinichiro Kawabe, Masahiro Gotoh, Shunsuke Ohta, Toshimitsu Tanaka, Shin Kuwakado, Hitoshi Nishitani and Ken-ichi Katsu

Department of Internal Medicine II, Osaka Medical College, Takatsuki, Osaka, Japan

For reprints and all correspondence: Takayuki Kii, Department of Internal Medicine II, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-0801, Japan. E-mail: in2058{at}poh.osaka-med.ac.jp

Received October 25, 2006; accepted April 19, 2007

Background: Recently, attention has been directed to concurrent chemoradiotherapy (CRT) for the treatment of squamous cell carcinoma of the esophagus with regard to efficacy, quality of life and functional preservation, and survival periods comparable to those after standard surgical therapy have been reported in responders to CRT. However, there are some non-responders to CRT, and the prediction of the outcome after CRT is an important subject for future studies. In this study, using biopsy specimens obtained before CRT, we evaluated the relationships between biological markers and the outcome after CRT in order to determine the prognostic factors of CRT.

Methods: The subjects were 51 patients (42 males and nine females: median age 68 years). who were histologically confirmed to have squamous cell carcinoma of the esophagus at stage II or III (UICC). Concurrent CRT consisting of chemotherapy using 5FU and CDDP and radiation therapy (60 Gy) was performed as the initial treatment, and the relationships of overexpression of EGFR, p53, VEGF, PCNA and CyclinD1 were examined immunohistochemically in biopsy specimens collected before treatment. Overall survival was estimated by multivariate analysis.

Results: The percentages of patients overexpressing p53, VEGF, PCNA, CyclinD1, and EGFR were 33, 31, 37, 31 and 29%, respectively. On multivariate analysis, T stage (P = 0.0393) and PCNA (P = 0.0302) were found to be significant prognostic factors.

Conclusions: PCNA overexpression appears to be a prognostic factor for squamous cell carcinoma of the esophagus after CRT.

Key Words: esophageal squamous cell carcinoma • chemoradiotherapy • PCNA • overall survival


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