Prognosis of esophageal squamous cell carcinoma: Analysis of clinicopathological and biological factors

Liang Shun Wang, Kuan Chih Chow, Kwan Hwa Chi, Chia Chuan Liu, Wing Yin Li, Jen Hwey Chiu, Min Hsiung Huang

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

OBJECTIVE: Esophageal squamous cell carcinoma (ESCC) is rather common among the Chinese, but the therapeutic outcome is dismal. Knowledge of the prognostic factors in cancerous patients may influence therapeutic strategy. However, systemic analyses of clinicopathological and biological factors for patients with ESCC are few, and the results are controversial. METHODS: Between 1985 and 1996, 117 patients undergoing en bloc esophagectomy and gastric substitution were enrolled. None had neoadjuvant treatment. Postoperative adjuvant therapy was provided for patients at and beyond stages IIa. Clinical responses were followed routinely. Flow cytometry was used to measure DNA ploidy and synthesis-phase fraction (SPF) of the resected esophageal tissues from all patients. Immunohistochemistry was also used to examine the expression of proliferating cell nuclear antigen (PCNA), epidermoid growth factor receptor (EGFR), HER2/neu, and p53 in the pathological sections. Clinical correlation was evaluated by X2 with Fisher's exact test, and survival by log-rank test. RESULTS: The overall survival rates were 74% for 1 yr, 48% for 3 yr, and 38% for 5 yr. TNM tumor staging, the number of diseased lymph nodes (N ≤ 3 or N > 3), degree of cell differentiation, DNA ploidy, SPF, and lymphovascular invasion were more useful than biological markers, such as PCNA, EGFR, HER-2/neu, and p53, for the prognosis of ESCC. Multivariate analysis revealed significant correlation of tumor staging and number of diseased lymph nodes with patient survival after surgery. CONCLUSIONS: En bloc esophagectomy may provide a rather satisfactory survival rate for patients with early stage ESCC. However, for patients with distant lymph node metastasis and those with more than three lymph nodes involved, radical surgical resection, even combined with postoperative chemoradiotherapy, cannot improve survival. The prognostic value of biological markers, including PCNA, EGFR, HER-2/neu, and p53, however, is limited.

Original languageEnglish
Pages (from-to)1933-1940
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume94
Issue number7
DOIs
Publication statusPublished - Jul 1999
Externally publishedYes

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Biological Factors
Growth Factor Receptors
Neoplasm Staging
Proliferating Cell Nuclear Antigen
Lymph Nodes
Esophagectomy
Ploidies
Survival
Survival Rate
Biomarkers
Neoadjuvant Therapy
Esophageal Squamous Cell Carcinoma
DNA
Chemoradiotherapy
Cell Differentiation
Stomach
Flow Cytometry
Therapeutics
Multivariate Analysis
Immunohistochemistry

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Prognosis of esophageal squamous cell carcinoma : Analysis of clinicopathological and biological factors. / Wang, Liang Shun; Chow, Kuan Chih; Chi, Kwan Hwa; Liu, Chia Chuan; Li, Wing Yin; Chiu, Jen Hwey; Huang, Min Hsiung.

In: American Journal of Gastroenterology, Vol. 94, No. 7, 07.1999, p. 1933-1940.

Research output: Contribution to journalArticle

Wang, Liang Shun ; Chow, Kuan Chih ; Chi, Kwan Hwa ; Liu, Chia Chuan ; Li, Wing Yin ; Chiu, Jen Hwey ; Huang, Min Hsiung. / Prognosis of esophageal squamous cell carcinoma : Analysis of clinicopathological and biological factors. In: American Journal of Gastroenterology. 1999 ; Vol. 94, No. 7. pp. 1933-1940.
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abstract = "OBJECTIVE: Esophageal squamous cell carcinoma (ESCC) is rather common among the Chinese, but the therapeutic outcome is dismal. Knowledge of the prognostic factors in cancerous patients may influence therapeutic strategy. However, systemic analyses of clinicopathological and biological factors for patients with ESCC are few, and the results are controversial. METHODS: Between 1985 and 1996, 117 patients undergoing en bloc esophagectomy and gastric substitution were enrolled. None had neoadjuvant treatment. Postoperative adjuvant therapy was provided for patients at and beyond stages IIa. Clinical responses were followed routinely. Flow cytometry was used to measure DNA ploidy and synthesis-phase fraction (SPF) of the resected esophageal tissues from all patients. Immunohistochemistry was also used to examine the expression of proliferating cell nuclear antigen (PCNA), epidermoid growth factor receptor (EGFR), HER2/neu, and p53 in the pathological sections. Clinical correlation was evaluated by X2 with Fisher's exact test, and survival by log-rank test. RESULTS: The overall survival rates were 74{\%} for 1 yr, 48{\%} for 3 yr, and 38{\%} for 5 yr. TNM tumor staging, the number of diseased lymph nodes (N ≤ 3 or N > 3), degree of cell differentiation, DNA ploidy, SPF, and lymphovascular invasion were more useful than biological markers, such as PCNA, EGFR, HER-2/neu, and p53, for the prognosis of ESCC. Multivariate analysis revealed significant correlation of tumor staging and number of diseased lymph nodes with patient survival after surgery. CONCLUSIONS: En bloc esophagectomy may provide a rather satisfactory survival rate for patients with early stage ESCC. However, for patients with distant lymph node metastasis and those with more than three lymph nodes involved, radical surgical resection, even combined with postoperative chemoradiotherapy, cannot improve survival. The prognostic value of biological markers, including PCNA, EGFR, HER-2/neu, and p53, however, is limited.",
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T2 - Analysis of clinicopathological and biological factors

AU - Wang, Liang Shun

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AU - Li, Wing Yin

AU - Chiu, Jen Hwey

AU - Huang, Min Hsiung

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