Biologic Factors Associated with Tumor Oxygenation Are Prognostic in Patients with Stage III Esophageal Cancer: Long-term Results

Background/Aim: Long-term results of a study investigating potential prognostic factors for treatment outcomes in patients with stage III esophageal cancer are presented. Patients and Methods: In 64 patients, the impact of tumor cell expression of erythropoietin (EPO) and erythropoietin-receptor (EPO-R) and ten additional factors (age, gender, performance status, tumor length, tumor stage (T-stage), nodes (N-stage), histology/grading, hemoglobin levels during radiotherapy, surgery) on survival and loco-regional control was evaluated up to 10 years following radio-chemotherapy. Results: On multivariate analysis, improved survival was associated with low EPO-R expression (p=0.034) and hemoglobin levels during radiotherapy. >= 12 g/dl (p=0.026). Low EPO expression was associated with survival on univariate (p=0.010) but not on multivariate analysis (p=0.42). On multivariate analysis, improved loco-regional control was significantly associated with hemoglobin levels during radiotherapy >= 12 g/dl (p<0.001). Conclusion: The long-term results confirm that hemoglobin levels during radiotherapy and tumor cell expression of EPO-R are significant prognostic factors in patients with locally advanced esophageal cancer.