RAD51 Expression as a Biomarker to Predict Efficacy of Preoperative Therapy and Survival for Esophageal Squamous Cell Carcinoma: A Large-cohort Observational Study (KSCC1307)
| Autor: | Tomoko Jogo, Mototsugu Shimokawa, Akitaka Makiyama, Tomotaka Shibata, Minako Fujiwara, Yuichiro Nakashima, Masaru Morita, Tomohiro Kamori, Yasunori Emi, Yoko Zaitsu, Masaki Mori, Yasue Kimura, Yoshifumi Baba, Eiji Oki, Tetsu Nakamura, Hiroshi Saeki, Shoji Tokunaga, Tetsuro Kawazoe, Akinori Egashira, Tomonori Nakanoko, Naoki Iwata, Yoshihiro Tanaka, Yu Nakaji |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
medicine.medical_specialty Esophageal Neoplasms Subgroup analysis Docetaxel 03 medical and health sciences 0302 clinical medicine Internal medicine Biopsy Antineoplastic Combined Chemotherapy Protocols medicine Humans neoplasms Pathological medicine.diagnostic_test business.industry Retrospective cohort study Chemoradiotherapy Prognosis Treatment Outcome 030220 oncology & carcinogenesis Carcinoma Squamous Cell Biomarker (medicine) Immunohistochemistry 030211 gastroenterology & hepatology Surgery Observational study Esophageal Squamous Cell Carcinoma Fluorouracil Rad51 Recombinase Cisplatin business Biomarkers |
| Zdroj: | Annals of surgery. 275(4) |
| ISSN: | 1528-1140 |
| Popis: | OBJECTIVE The aim of this study is to identify biomarkers that predict efficacy of preoperative therapy and survival for esophageal squamous cell carcinoma (ESCC). BACKGROUND It is essential to improve the accuracy of preoperative molecular diagnostics to identify specific patients who will benefit from the treatment; thus, this issue should be resolved with a large-cohort, retrospective observational study. METHODS A total of 656 patients with ESCC who received surgery after preoperative CDDP + 5-FU therapy, docetaxel + CDDP + 5-FU therapy or chemoradiotherapy (CRT) were enrolled. Immunohistochemical analysis of TP53, CDKN1A, RAD51, MutT-homolog 1, and programmed death-ligand 1 was performed with biopsy samples obtained before preoperative therapy, and expression was measured by immunohistochemistry. RESULTS In all therapy groups, overall survival was statistically separated by pathological effect (grade 3 > grade 2 > grade 0, 1, P < 0.0001). There was no correlation between TP53, CDKN1A, MutT-homolog 1, programmed death-ligand 1 expression, and pathological effect, whereas the proportion of positive RAD51 expression (≥50%) in cases with grade 3 was lower than that with grade 0, 1, and 2 (P = 0.022). In the CRT group, the survival of patients with RAD51-positive tumor was significantly worse than RAD51-negative expressors (P = 0.0119). Subgroup analysis of overall survival with respect to positive RAD51 expression indicated preoperative chemotherapy (CDDP + 5-FU or docetaxel + CDDP + 5-FU) was superior to CRT. CONCLUSIONS In ESCC, positive RAD51 expression was identified as a useful biomarker to predict resistance to preoperative therapy and poor prognosis in patients who received preoperative CRT. Administration of preoperative chemotherapy may be warranted for patients with positive RAD51 expression. |
| Databáze: | OpenAIRE |
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