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Ann Thorac Surg 2001;72:859-866
© 2001 The Society of Thoracic Surgeons

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Original article: general thoracic

Tumor marker expression is predictive of survival in patients with esophageal cancer

^a Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA
^b Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
^c National Cancer Institute, Bethesda, Maryland, USA

Address reprint requests to Dr D’Amico, Duke University Medical Center, Box 3496, Durham, NC 27710
e-mail: damic001{at}mc.duke.edu

Presented at the Forty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Marco Island, FL, Nov 9–11, 2000.

Background. This study was designed to determine the prognostic value of immunohistochemical tumor marker expression in a population of patients with node-negative esophageal cancer treated with complete resection alone.

Methods. Resection specimens were collected from 61 patients with node-negative T1 (n = 31), T2 (n = 14), and T3 (n = 16) esophageal cancer. A panel of 10 tumor markers was chosen for immunohistochemical analysis, based on associations with differing oncologic mechanisms: apoptosis (p53), growth regulation (transforming growth factor-, epidermal growth factor receptor, and Her2-neu), angiogenesis (factor VIII), metastatic potential (CD44), platinum resistance (p-glycoprotein and metallothionein), 5-fluorouracil resistance (thymidylate synthetase), and carcinogenic detoxification (glutathione S-transferase-).

Results. Complete resection was performed in all patients (44 adenocarcinoma, 17 squamous cell carcinoma), with no operative deaths. Multivariable analysis demonstrated a significant relationship between cancer-specific death and the following variables: low-level P-gp expression (p = 0.004), high-level expression of p53 (p = 0.04), and low-level expression of transforming growth factor- (p = 0.03). In addition, the number of involved tumor markers present was strongly predictive of negative outcome (p = 0.0001).

Conclusions. This study supports the prognostic value of immunohistochemical tumor markers, specifically the expression pattern of P-gp, p53, and transforming growth factor-, in patients with esophageal carcinoma treated with complete resection alone.

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