p53 gene protein overexpression predicts results of trimodality therapy inesophageal cancer patients

Background. P53 protein overexpression in esophageal cancer and its correla tion with response and survival after chemoradiation was retrospectively in vestigated. Methods. Pretreatment and resection specimens were stained by automatic p53 immunohistochemical staining technique. Results. P53 was expressed in 84.0% of esophagoscopy (EGD) biopsies; 71.4% of patients with metastasis of thoracoscopy/laparoscopy lymph nodes (TS/LS LN) identified by hematoxylin/eosin (WE) were p53 (+); 14.2% of patients wi th negative TS/LS LN by WE were p53 (+). Eleven out of 18 patients with p53 (+) in pretreatment EGD remained p53 (+) after chemoradiation; 38.8% of th ese patients had a pathological complete response (pCR). The median surviva l of this group was 15 months. Of 4 patients with p53 (-) pretreatment EGD, all of those were still p53 (-) after chemoradiation; 75% of these patient s had pCR. The median survival was 30 months. In patients with p53 (+) TS/L S LN, 23% had a pCR after chemoradiation with a median survival of 16 month s. In patients with p53 (-) TS/LS LN, 50.0% had a pCR with a median surviva l of 31.5 months. Conclusions. P53 protein overexpression in pretreatment EGD and TS/LS LN ma y predict response to chemoradiation and survival in esophageal cancer pati ents. (C) 1999 by The Society of Thoracic Surgeons.