Histological response of cisplatin predicts patients' survival in oesophageal cancer and p53 protein accumulation in pretreatment biopsy is associated with cisplatin sensitivity

The aim of this study was to evaluate whether cisplatin sensitivity relates to patient's prognosis in oesophageal squamous cell carcinoma and to find a useful chemosensitivity molecular marker. 59 oesophageal squamous cell ca rcinoma (SCC) patients received cisplatin 30 mg/m(2)/week treatment of two to five cycles, followed by oesophagectomy. We analysed retrospectively whe ther the histological effect was related to patient's prognosis. Furthermor e, to evaluate the relationship between the effect of preoperative cisplati n treatment and p53 and cyclin D1 expression, we investigated p53 and cycli n D1 expression in pretreatment biopsy samples using an immunohistochemical analysis and compared the results with the histological effect to cisplati n in the resected oesophagus. The cases that showed immunohistochemical p53 staining in the pretreatment biopsy samples were resistant to cisplatin (P =0.032). However, there was no relationship between cyclin DI expression an d histological effect (P=0.230). Nevertheless, combined analysis of p53 and cyclin D1 can predict histological effect (P= 0.032). The prognosis of cis platin-sensitive cases was significantly better than that of cisplatin-resi stant cases (P=0.041). Cox's multivariate analysis revealed that the histol ogical effect was an independent prognostic factor. In contrast, p53 protei n accumulation and cyclin D1 were not. Histological response after neoadjuv ant cisplatin treatment is a prognostic factor for oesophageal SCC and cisp latin chemotherapy may be selected according to the findings of p53 and cyc lin D1 expression. (C) 2000 Elsevier Science Ltd. All rights reserved.