Prognostic factors in esophageal cancer.

BACKGROUND/AIMS: Despite the advances in surgical treatment and the improvements in perioperative care for esophageal cancer, the long-term prognosis of this disease is poor. To improve long-term survival, it is essential to identify prognostic factors. This paper deals with the prognostic factors in esophageal cancer after potentially curative resection. Furthermore, correlation of the genetic alteration obtained from biopsy specimens with the prognostic factor was determined.

METHODOLOGY

A total of 102 patients, who underwent transthoracic esophagectomy, were retrospectively analyzed. In 18 recent patients, the genetic alteration of E-cadherin, cyclin D1, and p16INK4 were evaluated in the biopsy specimens.

RESULTS

Univariate analysis revealed that the number of metastatic lymph nodes and the tumor diameter significantly influenced prognosis. A Cox proportional regression hazard model showed that only the number of metastatic lymph nodes significantly affected prognosis. Overexpression of E-cadherin and amplification of cyclin D1 was correlated with the number of metastatic lymph nodes but not with p16INK4.

CONCLUSIONS

Preoperative genetic assessment of biopsy specimens obtained endoscopically provides useful information concerning selection of treatment modalities.