Abstract 3818: Tumor budding and E-cadherin expression are useful predictors of nodal involvement in T1 esophageal squamous cell carcinoma

Abstract

Abstract Background The endoscopic treatment has been increasingly used for T1 esophageal squamous cell carcinoma (ESCC). However, this therapy is sometimes incomplete if the depth of the T1 primary tumor reaches the muscularis mucosae (MM) or submucosal layer (SM) because these tumors have relatively high incidences of lymph node metastasis. However, no previous report on the predictive factor of nodal metastasis determined by evaluating primary tumor specimens of patients with ESCC is available. Patients and Methods A total of 55 patients with T1 ESCC invading as deep as the submucosal layer who underwent curative esophagectomy were examined. We investigated the significance of the immunohistochemical stainings of VEGF-C and E-cadherin in the primary tumor and tumor budding for prediction of nodal metastasis. Results Metastasis to the regional lymph nodes was observed in 26 cases (47.3%) in this setting. VEGF-C expression and reduced E-cadherin expression in the primary tumor was observed in 32 (58.1%) and 38 cases (69.1%), respectively. High-grade tumor budding was observed in 29 cases (52.7%). E-cadherin expression and tumor budding were closely correlated with nodal metastasis (p = 0.039 and <0.01 respectively), whereas VEGF-C expression tended to correlate with lymph node metastasis (p = 0.055). In addition, high-grade tumor budding was significantly correlated (p < 0.01) with reduced E-cadherin expression. The accuracies of tumor budding and E-cadherin expression for nodal metastasis were 67.3% and 65.4% respectively, which were comparable with those of lymphatic involvement (63%). Tumor budding (p < 0.01), but not E-cadherin and VEGF-C expression, was significantly correlated with poor survival. Conclusion After the endoscopic treatment, additional therapy, such as surgery or chemoradiotherapy, may be required if reduced E-cadherin expression and high-grade tumor budding are observed in the primary tumor specimen. Citation Format: Naoshi Kubo, Masaichi Ohira, Katsunobu Sakurai, Takahiro Toyokawa, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Kiyoshi Maeda, Naoyoshi Onoda, Kosei Hirakawa. Tumor budding and E-cadherin expression are useful predictors of nodal involvement in T1 esophageal squamous cell carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3818. doi:10.1158/1538-7445.AM2014-3818