Prognostic significance of Ku80 in pT2N0M0 esophageal squamous cell carcinoma after Ivor-Lewis esophagectomy

Meta-analysis of prognostic factors of overall survival in patients undergoing oesophagectomy for oesophageal cancer

INTRODUCTION

Currently, the American Joint Commission on Cancer (AJCC) staging system is used for prognostication for oesophageal cancer. However, several prognostically important factors have been reported but not incorporated. This meta-analysis aimed to characterize the impact of preoperative, operative, and oncological factors on the prognosis of patients undergoing curative resection for oesophageal cancer.

METHODS

This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus, and Cochrane CENTRAL databases up to 31 December 2018. A meta-analysis was conducted with the use of random-effects modeling to determine pooled univariable hazard ratios (HRs). The study was prospectively registered with the PROSPERO database (Registration: CRD42018157966).

RESULTS

One-hundred and seventy-one articles including 73,629 patients were assessed quantitatively. Of the 122 factors associated with survival, 39 were significant on pooled analysis. Of these. the strongly associated prognostic factors were 'pathological' T stage (HR: 2.07, CI95%: 1.77-2.43, P < 0.001), 'pathological' N stage (HR: 2.24, CI95%: 1.95-2.59, P < 0.001), perineural invasion (HR: 1.54, CI95%: 1.36-1.74, P < 0.001), circumferential resection margin (HR: 2.17, CI95%: 1.82-2.59, P < 0.001), poor tumor grade (HR: 1.53, CI95%: 1.34-1.74, P < 0.001), and high neutrophil:lymphocyte ratio (HR: 1.47, CI95%: 1.30-1.66, P < 0.001).

CONCLUSION

Several tumor biological variables not included in the AJCC 8th edition classification can impact on overall survival. Incorporation and validation of these factors into prognostic models and next edition of the AJCC system will enable personalized approach to prognostication and treatment.

High expression of cyclooxygenase 2 is an indicator of prognosis for patients with esophageal squamous cell carcinoma after Ivor Lewis esophagectomy

BACKGROUND

The poor prognosis of esophageal squamous cell carcinoma (ESCC) is attributed to a high recurrence rate after surgery. Cyclooxygenase 2 (COX2) is an important regulator of cell growth, differentiation, apoptosis, and transformation. COX2 overexpression is significantly associated with the tumorigenesis and progression of diverse cancers; however, its expression and significance in ESCC remains unclear.

METHODS

We enrolled 118 patients with ESCC who had undergone Ivor-Lewis esophagectomy. The expression profile of COX2 was examined by immunohistochemistry.

RESULTS

A high expression of COX2 correlated with a higher T staging (P = 0.014), lower differentiation degree (P = 0.002), lymph node metastasis (P = 0.009), recurrence status (P = 0.004), and tumor node metastasis (TNM) stage (P = 0.001). Cox regression analysis showed that TNM stage (P = 0.001), differentiation degree (P = 0.001), and high COX2 expression (P = 0.004) were independent risk factors of prognosis.

CONCLUSION

Our data indicated that COX2 expression level is associated with key clinicopathological features and could be an effective biomarker to predict ESCC prognosis.