Department of Clinical Oncology, Toho University Graduate School of Medicine, Tokyo, Japan.
Department of Surgery, School of Medicine, Toho University, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2022 Jun 20;28(3):163-170. doi: 10.5761/atcs.oa.21-00195. Epub 2022 Jun 17.
The prognostic significance of pretreatment serum C-terminus of cytokeratin 19 (CYFRA21-1, CYFRA) status was evaluated in the patients with surgically treated esophageal squamous cell carcinoma.
A total of 1047 patients with surgically treated esophageal cancer were enrolled in a multi-institutional study promoted by the Japanese Esophageal Society. This study included an up-front surgery group (n = 412), a neoadjuvant chemotherapy (NAC) group (n = 486), and a neoadjuvant chemoradiation/radiation therapy (NACRT/RT) group (n = 149). The pretreatment CYFRA status was analyzed to assess prognostic significance using multivariate analysis according to treatment modalities.
The CYFRA-positive group was significantly associated with deep tumor. Univariate analysis showed that the overall survival of the CYFRA-positive group was significantly worse than that of the CYFRA-negative group, but the difference was not significant in the multivariate analysis. CYFRA was an independent risk factor for poor prognosis just in the NACRT/RT group.
The CYFRA-positive group was associated with deep tumor and poor survival. Pretreatment CYFRA was not an independent risk factor for poor prognosis in the up-front surgery group or NAC group. It was an independent risk factor for poor prognosis just in the NACRT/RT group.
评估术前血清细胞角蛋白 19 羧基末端(CYFRA21-1,CYFRA)状态对接受手术治疗的食管鳞状细胞癌患者的预后意义。
共有 1047 名接受手术治疗的食管癌患者参加了由日本食管学会推动的多机构研究。该研究包括直接手术组(n=412)、新辅助化疗(NAC)组(n=486)和新辅助放化疗/放疗(NACRT/RT)组(n=149)。根据治疗方式,通过多变量分析来评估术前 CYFRA 状态与预后的关系。
CYFRA 阳性组与肿瘤深度显著相关。单因素分析显示,CYFRA 阳性组的总生存率明显差于 CYFRA 阴性组,但多因素分析显示差异无统计学意义。CYFRA 是 NACRT/RT 组预后不良的独立危险因素。
CYFRA 阳性组与肿瘤深度较深和生存不良相关。术前 CYFRA 不是直接手术组或 NAC 组预后不良的独立危险因素。它只是 NACRT/RT 组预后不良的独立危险因素。