Predictive value of c-met for long-term mortality in patients with esophageal squamous cell carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the correlation of c-met protein with the clinical staging and cell differentiation of esophageal squamous cell carcinoma (ESCC).</p><p><b>METHODS</b>A total of 100 patients with ESCC were enrolled were examined for expression of c-met protein using immunohistochemistry, and the patients in negative and positive c-met expression groups were compared for clinicopathological characteristics and overall survival.</p><p><b>RESULTS</b>s The 100 ESCC patients included 67 male and 33 female patients with a median age of 59 years; 49 of the patients were negative and 51 were positive for c-met expression. Positive c-met expression was significantly correlated with advanced TMN stages and lower tumor differentiation. Kaplan-Meier survival curve showed that the median survival time of c-met-positive patients was significantly reduced compared with that of c-met-negative patients (30.9 vs 48.2 months, P<0.05). COX regression analysis showed that c-met was a independent risk factor for the overall survival of the patients (HR: 2.34, 95% CI: 1.63-4.54, P<0.05).</p><p><b>CONCLUSION</b>A positive expression of c-met protein is significantly correlated with an advanced TMN stage, lower tumor differentiation and a poor prognosis, and may serve as a indicator for predicting the prognosis of ESCC.</p>

Clinicopathological characteristics and prognosis of young esophageal cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinicopathological features and prognosis of esophageal cancer between young and elderly patients.</p><p><b>METHODS</b>Clinical data of 716 patients with esophageal squamous cell carcinoma undergoing curative operation from January 1990 to December 1998 at the Cancer Center of Sun Yat-sen University were analyzed retrospectively. Clinicopathological features and prognosis of 117 patients aged ≤45 years (young group) at diagnosis were compared with 599 patients aged >45 years (elderly group).</p><p><b>RESULTS</b>Except for tumor stage, there were no significant differences of clinicopathology between the young group and the elderly group (all P>0.05). There were more pathologic stage III cancer in the young group than the elderly group (47.9% vs. 33.6%, P=0.010). The 5-year survival rate (36.0% vs 33.8%) and 10-year survival rate (29.2% vs 25.0%) were not significantly different between the two groups (P=0.418). Multivariate analysis showed that the age was not the independent prognostic factors of esophageal squamous cell carcinoma (P=0.160, RR=1.187, 95%CI:0.935-1.506).</p><p><b>CONCLUSION</b>Young esophageal cancer patients have more advanced tumors than elderly patients. However, the survival is comparable to the elderly.</p>

Clinical analysis of 22 cases of esophageal adenosquamous carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>This study was to review the clinical features, diagnosis, treatment, and prognosis of esophageal adenosquamous carcinoma (ASC).</p><p><b>METHODS</b>Clinical data of 22 patients with pathologically confirmed esophageal ASC, treated in the Cancer Center of Sun Yat-sen University from May 1988 to April 2006, were retrospectively analyzed. The survival analysis was performed using Kaplan-Meier method.</p><p><b>RESULTS</b>Of 4208 patients diagnosed as esophageal cancer during the same time in our center, only 22 had esophageal ASC, accounted for 0.52%. The median age of the 22 cases was 60 years (range, 42 to 69 years). Esophageal ASC showed similar clinical symptoms, radiological and endoscopic features to esophageal squamous cell carcinoma (ESCC). Nineteen cases were preoperatively misdiagnosed as ESCC by endoscopic biopsy. Among the 22 patients, 16 were treated by surgery alone, 3 by surgery plus postoperative radiotherapy, and the remaining 3 by radiotherapy, sequential chemoradiotherapy and concurrent chemoradiotherapy, each in one case, respectively. The overall 1-, 3- and 5-year survival rates were 67.6%, 33.8% and 18.1%, respectively, with a median survival time of 24.5 months.</p><p><b>CONCLUSION</b>Esophageal adenosquamous carcinoma is a rare esophageal disease and prone to be misdiagnosed as esophageal squamous cell carcinoma. Initial surgical treatment combined with other therapies is suggested. The prognosis of esophageal adenosquamous carcinoma has not yet been well established.</p>

Surgical treatment and prognosis in patients with squamous cell carcinoma of thoracic esophagus / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the prognostic factors of thoracic esophageal squamous cell carcinoma (ESCC) after esophagectomy.</p><p><b>METHODS</b>The clinicopathologic data of 716 patients with thoracic ESCC from January 1990 to December 1998 were analyzed retrospectively. There were 538 male and 178 female patients aged from 24 to 78 years old with a median of 57 years old. Cumulative survival rate was analyzed by the Kaplan-Meier method and compared by the Log-rank test. COX regression model was used for multivariate prognostic analysis.</p><p><b>RESULTS</b>The overall 1-, 3-, 5- and 10-year survival rates were 82.9%, 44.3%, 34.2% and 25.7% respectively. The 5-year survival rates was 80.0%, 51.2%, 19.7% and 13.3% for stage I, stage IIA, stage IIB and stage III respectively. Of the 716 patients, 151 (21.1%) patients recurred, including 48 (84.2%) of stage IIA recurrence, 22 (91.7%) of stage IIB recurrence and 63 (90.0%) of stage III recurrence occurred within 3 years postoperatively. Univariate analysis revealed that the factors impacting the prognosis were gender, depth of invasion, lymph node metastasis, pathologic stage, number of lymph node metastatic field, differentiation, surgical margin and tumor relapse. Multivariate analysis showed that depth of invasion, lymph node metastasis, pathologic stage and tumor relapse were independently associated to poor prognosis.</p><p><b>CONCLUSIONS</b>Depth of invasion, lymph node metastasis, pathologic stage and tumor relapse are the independent factors of ESCC. Surgery is still the primary treatment for stage I-IIA esophageal cancer; but it is suggested to adopt surgical treatment as primary modality combined with other therapies for stage IIB-III esophageal cancer.</p>