REG I expression predicts long-term survival among locally advanced thoracic squamous cell esophageal cancer patients treated with neoadjuvant chemoradiotherapy followed by esophagectomy

Satoru Motoyama, Toshihiro Sugiyama, Yasuharu Ueno, Hiroshi Okamoto, Shin Takasawa, Hiroshi Nanjo, Hitoshi Watanabe, Kiyotomi Maruyama, Manabu Okuyama, Jun Ichi Ogawa

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: The prognosis for patients with locally advanced thoracic esophageal cancer is extremely unfavorable. We have been administering neoadjuvant chemoradiotherapy (CRT) followed by esophagectomy to these patients and studying whether REG I expression in untreated endoscopic biopsy specimens is predictive of patient responsiveness to CRT and/or survival after treatment. Methods: Between 1992 and 2003, 47 patients with T4 (direct invasion of adjacent organs) thoracic esophageal cancers were administered neoadjuvant CRT followed by esophagectomy. REG I expression was assessed in untreated endoscopic biopsy specimens and correlated with clinical and histological responses and survival in 37 patients who had also undergone curative surgery. Results: Among the 37 cases that received CRT followed by surgery, the therapeutic response rate for neoadjuvant CRT was 68%, and a complete histological response in resected specimens from the primary lesion was achieved in 8 (22%) patients. These clinical and histological responses to neoadjuvant CRT did not significantly correlate with survival, however. By contrast, 9 patients were judged REG-positive based on analysis of their untreated endoscopic biopsy specimens, and their cumulative survival rate was significantly higher than that of the 28 REG-negative patients (P = 0.0073). Univariate analysis showed REG I expression to be a prognostic factor (P = 0.0386) that increased the risk of death 8.4-fold. Conclusions: Evaluation of REG I expression in untreated endoscopic biopsy specimens may provide a basis for new treatments of locally advanced thoracic squamous cell esophageal cancers.

Original languageEnglish
Pages (from-to)1724-1731
Number of pages8
JournalAnnals of Surgical Oncology
Volume13
Issue number12
DOIs
Publication statusPublished - 2006 Dec

Keywords

  • Chemoradiotherapy
  • Esophageal cancer
  • Esophagectomy
  • Prognosis
  • REG I

ASJC Scopus subject areas

  • Surgery
  • Oncology

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