Abstract
BackgroundThe overall survival of patients with esophageal squamous cell carcinoma (ESCC) remains poor. Prognostic predictions in ESCC are usually based on histological assessment of tumor invasion and lymph node metastasis, but a biomarker with better predictive accuracy could be more useful. Because overexpression of epidermal growth factor receptor (EGFR) has been associated with poor prognosis, this study investigated whether EGFR is an independent prognostic factor for overall survival and disease-free survival of ESCC patients.MethodsESCC tissue specimens from 243 patients obtained during surgical resection between 1980 and 1997 were retrieved for immunohistochemical analysis of EGFR expression.ResultsThe data showed that EGFR protein was overexpressed in 187 of 243 (77%) ESCC tissues. Elevated expression was associated with higher pathologic tumor stages (P = 0.001), lymph node metastasis (P = 0.002), and higher Union for International Cancer Control (UICC) stage (P <0.0001), as well as poorer disease-free survival and overall survival of ESCC patients (P <0.0001). A multivariate analysis showed that overexpression of EGFR protein was an independent factor for disease-free survival (P = 0.003) and overall survival (P = 0.001) of these patients. Subgroup analysis of patients with stage IIA (UICC 2002) showed that EGFR overexpression was associated with poorer disease-free survival (P = 0.007) and overall survival (P = 0.010) of the patients in univariate analyses.ConclusionsThe current study demonstrated that EGFR overexpression was an independent prognostic factor for overall survival and disease-free survival of ESCC patients. However, targeting of EGFR activity using gefitinib or erlotinib could be useful for clinical treatment of ESCC patients.
Highlights
The overall survival of patients with esophageal squamous cell carcinoma (ESCC) remains poor
We investigated correlations between epidermal growth factor receptor (EGFR) expression and clinicopathological data from the patients and found that EGFR expression was associated with advanced tumor stage (P = 0.001), tumor lymph node metastasis (P = 0.002), and higher pathological stages (UICC 2002 and 2010, P
Association of epidermal growth factor receptor expression with overall survival of esophageal squamous cell carcinoma patients We investigated correlations between EGFR expression in resected ESCC tissues and survival of ESCC patients and found that the 5-year OS and disease-free survival (DFS) rates of patients with EGFR expression were 15.0% and 14.4%, respectively, and the median survival times were 16.0 months and 11.6 months
Summary
The overall survival of patients with esophageal squamous cell carcinoma (ESCC) remains poor. Because overexpression of epidermal growth factor receptor (EGFR) has been associated with poor prognosis, this study investigated whether EGFR is an independent prognostic factor for overall survival and disease-free survival of ESCC patients. Determination of tumor stage in esophageal cancer is often imprecise making survival of patients difficult to predict, especially those in the late stages. In a subset of these cancers, most notably breast [15], colorectal [13,14], and esophageal cancers [16,17], increased EGFR expression has been associated with advanced disease, tumor metastases, and poor prognosis
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