Yukiharu Hiyoshi1, Naoya Yoshida1, Masayuki Watanabe2, Junji Kurashige1, Yoshifumi Baba1, Yasuo Sakamoto1, Hideo Baba3. 1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. 2. Esophageal Surgery, Gastroenterological Surgery, Gastroenterology Center, The Cancer Institute Hospital of JFCR (Japanese Foundation for Cancer Research), Koto, Japan. 3. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. hdobaba@kumamoto-u.ac.jp.
Abstract
BACKGROUND: Docetaxel, cisplatin and fluorouracil (DCF) is a candidate neoadjuvant chemotherapy (NAC) regimen for esophageal squamous cell carcinoma (ESCC). Although the efficacy and safety of DCF have been reported, the markers that predict the patient's response are still unknown. The aim of this study was to identify the predictive markers for a response to NAC with DCF in patients with ESCC. METHODS: A total of 79 patients who received preoperative DCF followed by esophagectomy between August 2008 and December 2014 were enrolled in this study. All of the patients completed 2 preoperative courses of DCF. The clinical and pathological responses to DCF were investigated, and the associations between the pathological response, the clinicopathological factors and the prognosis were retrospectively analyzed. RESULTS: Among the 79 patients, the pathological response to DCF (evaluated according to the Japanese Classification of Esophageal Cancer) was grade 3 (complete pathological response) in 7 patients (8.9 %), grade 2 in 13 patients (16.5 %), grade 1b in 8 patients (10.1 %) and grade 1a in 51 patients (64.6 %). A good pathological response (grade 2-3) was significantly associated with both favorable disease-free survival (P = 0.0051) and favorable cancer-specific survival (P = 0.0366). A multivariate analysis revealed that a good clinical response (HR 13.743, 95 % CI 2.455-76.917) and the presence of serum p53 antibody before treatment (HR 3.987, 95 % CI 1.103-14.416) were independent predictors of good pathological response. CONCLUSIONS: The presence of serum p53 antibody can be used as a novel, noninvasive predictor of the pathological tumor response to NAC with DCF in ESCC patients.
BACKGROUND:Docetaxel, cisplatin and fluorouracil (DCF) is a candidate neoadjuvant chemotherapy (NAC) regimen for esophageal squamous cell carcinoma (ESCC). Although the efficacy and safety of DCF have been reported, the markers that predict the patient's response are still unknown. The aim of this study was to identify the predictive markers for a response to NAC with DCF in patients with ESCC. METHODS: A total of 79 patients who received preoperative DCF followed by esophagectomy between August 2008 and December 2014 were enrolled in this study. All of the patients completed 2 preoperative courses of DCF. The clinical and pathological responses to DCF were investigated, and the associations between the pathological response, the clinicopathological factors and the prognosis were retrospectively analyzed. RESULTS: Among the 79 patients, the pathological response to DCF (evaluated according to the Japanese Classification of Esophageal Cancer) was grade 3 (complete pathological response) in 7 patients (8.9 %), grade 2 in 13 patients (16.5 %), grade 1b in 8 patients (10.1 %) and grade 1a in 51 patients (64.6 %). A good pathological response (grade 2-3) was significantly associated with both favorable disease-free survival (P = 0.0051) and favorable cancer-specific survival (P = 0.0366). A multivariate analysis revealed that a good clinical response (HR 13.743, 95 % CI 2.455-76.917) and the presence of serum p53 antibody before treatment (HR 3.987, 95 % CI 1.103-14.416) were independent predictors of good pathological response. CONCLUSIONS: The presence of serum p53 antibody can be used as a novel, noninvasive predictor of the pathological tumor response to NAC with DCF in ESCC patients.
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