P53 CORRELATES WITH IMPROVED SURVIVAL IN PATIENTS WITH ESOPHAGEAL ADENOCARCINOMA

Esophageal adenocarcinoma is a virulent malignancy that is rapidly inc reasing in incidence. Overexpression of p53, a tumor-suppressor gene w ith prognostic significance in many malignancies, has not been adequat ely evaluated in this disease. The purpose of this study was to evalua te the pattern and importance of p53 protein accumulation in patients with esophageal adenocarcinoma. Immunohistochemical analysis was per f ormed on formalin-fixed, paraffin-embedded tissue from 24 patients, al l of whom had early stage disease. Nineteen of 24 patients underwent s urgery, and 16 had complete tumor resection, p53 oncoprotein immunorea ctivity was demonstrated in 50% (12/24) of patients overall and 50% (8 /16) of patients undergoing esophagectomy. p53 overexpression was more common in patients with well-differentiated tumors (P = 0.07). The ti ssue surrounding tumor stained positive for p53 in six patients, four of whom had no evidence of Barrett's epithelium. Among the 16 patients who underwent esophagectomy, those whose tumors demonstrated p53 over expression had a longer overall (28 vs. 13.5 months) and disease-free (24.3 vs. 13 months) median survival. The difference in disease-free s urvival was significant (P = 0.05). Our findings suggest that p53 over expression may serve as a marker of improved survival in patients with esophageal adenocarcinoma. (C) 1995 Wiley-Liss, Inc.