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Published in: Annals of Surgical Oncology 12/2006

01-12-2006

REG I Expression Predicts Long-term Survival among Locally Advanced Thoracic Squamous Cell Esophageal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy Followed by Esophagectomy

Authors: Satoru Motoyama, MD, Toshihiro Sugiyama, MD, Yasuharu Ueno, MD, Hiroshi Okamoto, MD, Shin Takasawa, MD, Hiroshi Nanjo, MD, Hitoshi Watanabe, Kiyotomi Maruyama, MD, Manabu Okuyama, MD, Jun-ichi Ogawa, MD

Published in: Annals of Surgical Oncology | Issue 12/2006

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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.
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Metadata
Title
REG I Expression Predicts Long-term Survival among Locally Advanced Thoracic Squamous Cell Esophageal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy Followed by Esophagectomy
Authors
Satoru Motoyama, MD
Toshihiro Sugiyama, MD
Yasuharu Ueno, MD
Hiroshi Okamoto, MD
Shin Takasawa, MD
Hiroshi Nanjo, MD
Hitoshi Watanabe
Kiyotomi Maruyama, MD
Manabu Okuyama, MD
Jun-ichi Ogawa, MD
Publication date
01-12-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9075-z

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