HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Imdahl, A. Articles by Ihling, C. Search for Related Content PubMed PubMed Citation Articles by Imdahl, A. Articles by Ihling, C. Related Collections Esophagus - cancer

Eur J Cardiothorac Surg 2002;21:657-663
© 2002 Elsevier Science NL

Predictive factors for response to neoadjuvant therapy in patients with oesophageal cancer

^a Department of Surgery, Division of General Surgery, University of Freiburg, Hugstetterstrasse 55, 79106 Freiburg, Germany
^b II. Department of Surgery, Semmelweis University of Budapest, Budapest, Hungary
^c Department of Biomedicine and Statistics, University of Freiburg, Freiburg, Germany
^d Department of Pathology, University of Freiburg, Freiburg, Germany

Received 11 September 2001; received in revised form 11 January 2002; accepted 11 January 2002.

* Corresponding author. Tel.: +49-761-2702401; fax: +49-761-2702804
e-mail: imdahl{at}chir.ukl.uni-freiburg.de

Background: Preoperative radio-chemotherapy (RCX) was introduced to improve the outcome of patients with oesophageal cancer (EC), but conflicting results have been released. Some 20–30% of patients show a complete pathological response, however, the perioperative morbidity and mortality is increased. To search for factors indicating response prior to the onset of RCX we investigated the proliferative activity (MIB-1), the expression of vascular endothelial growth factor (VEGF), and the capillary density (CD34) in samples of EC obtained by endoscopy prior to the start of the treatment. Methods: Forty-six (MIB-1) and 21 (VEGF, CD34) tissue specimens of ECs were available from 56 patients undergoing pretherapeutic endoscopy, RCX and surgery. Perioperative morbidity was divided into surgery and non-surgery related morbidity. MIB-1, VEGF and CD34 expression were investigated immunohistochemically. Multivariate analysis was carried out to prove independence of investigated variables. Results: Postoperative morbidity was noticed in 54 of 56 operated patients. Eight of 56 patients who received RCX died in hospital. Survival was significantly different between the group of complete responders (n=14) and non-responders (n=23; P=0.0026). None of the investigated tumour samples from patients with a complete response (CR) had a proliferation index of less than 45. Tumour samples from patients with a CR showed a VEGF expression of 10.7 compared with 36.58 of tumours with no response (P=0.035). CD34 expression showed a correlation with VEGF expression. The relation of mean indices of VEGF expression and proliferative activity in tumours from patients with complete, partial or no response was 10.7:58.8, 18.3:53.8 and 36.6:43.5, respectively. Conclusions: According to these results, it may be expected that tumours with a VEGF/MIB-1 ratio of 1:6 or less prior to RCX will respond to this therapy.

Key Words: Oesophageal cancer • Neoadjuvant therapy • Predictive factors

Abbreviations: RCX, radio-chemotherapy • EC, oesophageal cancer • VEGF, vascular endothelial growth factor • CR, complete response • PR, partial response • NR, no response/tumour progress

This article has been cited by other articles:

				K R Fareed, P Kaye, I N Soomro, M Ilyas, S Martin, S L Parsons, and S Madhusudan Biomarkers of response to therapy in oesophago-gastric cancer Gut, January 1, 2009; 58(1): 127 - 143. [Abstract] [Full Text] [PDF]

				S. Ekman, M. Bergqvist, C.-H. Heldin, and J. Lennartsson Activation of Growth Factor Receptors in Esophageal Cancer Implications for Therapy Oncologist, October 1, 2007; 12(10): 1165 - 1177. [Abstract] [Full Text] [PDF]

				W. P. Tew, D. P. Kelsen, and D. H. Ilson Targeted Therapies for Esophageal Cancer Oncologist, September 1, 2005; 10(8): 590 - 601. [Abstract] [Full Text] [PDF]

				M. H. Kulke, R. D. Odze, J. D. Mueller, H. Wang, M. Redston, and M. M. Bertagnolli Prognostic significance of vascular endothelial growth factor and cyclooxygenase 2 expression in patients receiving preoperative chemoradiation for esophageal cancer J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1579 - 1586. [Abstract] [Full Text] [PDF]

				M. Koshy, N. Esiashvilli, J. C. Landry, C. R. Thomas Jr., and R. H. Matthews Multiple Management Modalities in Esophageal Cancer: Combined Modality Management Approaches Oncologist, April 1, 2004; 9(2): 147 - 159. [Abstract] [Full Text] [PDF]