Patients with ERCCI-negative locally advanced esophageal cancers may benefit from preoperative chemoradiotherapy

Min Kyoung Kim, Kyung Ja Cho, Gui Young Kwon, Seung Il Park, Yong Hee Kim, Jong Hoon Kim, Ho Young Song, Ji Hoon Shin, Hwoon Yong Jung, Gin Hyug Lee, Kee Don Choi, Sung Bae Kim

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Purpose: To assess the significance of excision repair cross- complementation group 1 (ERCC1) expression as a predictive marker, we analyzed the effects of preoperative chemoradiotherapy on survival relative to ERCC1 status in patients with locally advanced operable esophageal cancer. Experimental Design: Paraffin-embedded pretreatment tumor specimens, collected by endoscopic biopsy from patients treated with surgery alone or with preoperative chemoradiotherapy followed by surgery, were immunohistochemically assayed for ERCC1 expression. Results: Of the 175 patients, 152 biopsy specimens were available for immunohistochemical analysis. Based on a median ERCC1 expression score of 1, we divided the samples into ERCC1- positive (score >1; 71 patients, 47%) and ERCC1-negative (score ≤1; 81 patients, 53%) groups. No differences in patient and disease characteristics were observed between the two groups. However, among patients with ERCC1-negative tumors, those who received preoperative chemoradiotherapy had longer overall survival (OS) and event-free survival (EFS) than those treated with esophagectomy alone (median OS, 59.2 versus 25.4 months, P = 0.057; median EFS, 50.7 versus 19.7 months, P = 0.042). This difference was not observed among patients with ERCC1-positive tumors. In multivariate analysis, treatment modality was the major determinant of both EFS (P = 0.006) and OS (P = 0.008) for patients with ERCCI - negative tumors, whereas Eastern Cooperative Oncology Group performance status was the only significant predictor of outcome among ERCC1-positive patients. Among patients who received esophagectomy alone, those with ERCC1-positive tumors had a tendency toward longer OS and EFS (P = 0.085 and 0.094, respectively). Conclusions: Patients with ERCC1 -negative operable esophageal tumors show a greater benefit from preoperative chemoradiotherapy followed by esophagectomy than those who undergo esophagectomy alone.

Original languageEnglish (US)
Pages (from-to)4225-4231
Number of pages7
JournalClinical Cancer Research
Issue number13
StatePublished - Jul 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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