Detection Of Epidermal Growth Factor Receptor Mutation In Esophageal Cancer And Gastric Cancer And The Study On Postoperative Adjuvant Treatment In Esophageal Cancer Patients

Objective TKIs of the EGFR have been reported to be effective in esophageal cancer and cancer of the esophagogastric junction. So we aimed to detect the frequency of EGFR mutation and expression in Chinese patients with esophageal cancer, cancer of the EGJ and gastric cancer, and to clarify the value of EGFR mutation and expression in predicting the efficacy of TKI in these tumors.Methods In this study,180tumor samples with histologically confirmed esophageal cancer (39cases), cancer of the esophagogastric junction (92cases) or gastric cancer (49cases) were collected.Twenty-nine different EGFR mutations in exons18～21were assessed by real-time PCR-optimized oligonucleotide probe method. EGFR protein expression was evaluated by IHC in89tumor samples. Results Mutation analysis for EGFR (exons18～21) showed no mutations in any of the hotspots of the gene in the180tumor samples analyzed. EGFR expression was negative in12tumor samples,1+in31tumor samples,2+in24tumor samples, and3+in22tumor samples. EGFR expression was2+or3+in12(92.3%) of the13esophageal squamous cell carcinomas,29(47.6%) of the61cancers of the esophagogastric junction, and5(33.3%) of the15gastric adenocarcinomas.Conclusions Our results indicate that EGFR mutation in exons18～21was absent in the detected samples of esophageal cancer, cancer of the EGJ and gastric cancer. More studies in these patients should be warranted to explore the predictive biologic markers for the therapeutic response to EGFR-TKI. Background:ESCC patients with locoregional lymph node metastases have poor prognosis after surgery. The purpose of this study was to investigate the impact of various treatment modalities on survival in these patients.Methods:We retrospectively reviewed data from349patients who had undergone left transthoracic esophagectomy for thoracic ESCC from January2008to December2010at our institute. All patients had lesions in the mid or lower third of the thoracic segment and had pathological positive lymph node metastasis. Of these patients,143patients received surgery alone,154patients underwent postoperative radiotherapy alone, and52patients underwent taxane-based chemotherapy. Univariate and multivariate Cox regression analyses were used to analyze prognostic factors and survival.Results:At a median follow-up of53.1months, the3-year OS were47.7%for the patients with surgery alone,44.0%for the patients with adjuvant radiotherapy, and58.9%for the patients with adjuvant chemotherapy. Multivariate analysis showed that postoperative therapy with adjuvant, chemotherapy was significant positive predictor of survival.Conclusions:Postoperative taxane-based adjuvant chemotherapy improved survival of patients with lymph node positive thoracic ESCC compared with surgery alone. Further randomized prospective studies to confirm these findings are warranted.