p53 gene protein overexpression predicts results of trimodality therapy in esophageal cancer patients

Background. P53 protein overexpression in esophageal cancer and its correlation with response and survival after chemoradiation was retrospectively investigated. 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 with 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 these patients had a pathological complete response (pCR). The median survival of this group was 15 months. Of 4 patients with p53 (-) pretreatment EGD, all of those were still p53 (-) after chemoradiation; 75% of these patients had pCR. The median survival was 30 months. In patients with p53 (+) TS/LS LN, 23% had a pCR after chemoradiation with a median survival of 16 months. In patients with p53 (-) TS/LS LN, 50.0% had a pCR with a median survival of 31.5 months. Conclusions. P53 protein overexpression in pretreatment EGD and TS/LS LN may predict response to chemoradiation and survival in esophageal cancer patients. (C) 1999 by The Society of Thoracic Surgeons.