Removable Internally Covered Self-Expandable Metal Stents During Neoadjuvant Therapy for Locally Advanced Esophageal Cancer

2008 ◽  
Vol 103 ◽  
pp. S36
Author(s):  
Tercio Lopes ◽  
Mohamad Eloubeidi
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Locally Advanced ◽  
Metal Stents ◽  
Advanced Esophageal Cancer ◽  
Locally Advanced Esophageal Cancer

Survivin expression in esophageal cancer: Association with histomorphological response to neoadjuvant therapy and prognosis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4536-4536 ◽  
Author(s):  
D. Vallboehmer ◽  
E. Kuhn ◽  
J. Brabender ◽  
R. Metzger ◽  
U. Warnecke-Eberz ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Protein Expression ◽  
Neoadjuvant Therapy ◽  
Locally Advanced ◽  
Survivin Expression ◽  
Neoadjuvant Radiochemotherapy ◽  
Advanced Esophageal Cancer ◽  
Survivin Protein ◽  
Histopathologic Response ◽  
Locally Advanced Esophageal Cancer

4536 Background: The poor prognosis associated with locally advanced esophageal cancer prompted an evaluation of combined modality treatments including neoadjuvant radiochemotherapy in combination with surgery. However, it has been well established that only patients with a complete pathological response to neoadjuvant therapy will have a significant survival benefit. Therefore, predictive markers to allow a tailored radiochemotherapy are needed. The aim of this study was to examine the association of the protein expression of survivin, an inhibitor of apoptosis, with histopathologic response to neoadjuvant radiochemotherapy and prognosis of patients with locally-advanced esophageal cancer. Methods: 59 patients with esophageal cancer (cT2–4, Nx, M0) received neoadjuvant radiochemotherapy (cisplatin, 5-FU, 36 Gy) followed by esophagectomy. Histomorphologic regression was defined as major response when resected specimens contained less than 10 % and as minor response when resected specimens contained more than 10 % of residual vital tumor cells. Pre- and post-therapeutic intratumoral protein expression of survivin was determined and correlated with clinicopathologic parameters. Results: The pre-therapeutic intratumoral survivin protein expression was not associated with any clinicopathologic factor, including histopathologic response and prognosis. Survivin protein expression was significantly reduced during neoadjuvant therapy, showing lower levels in post-therapeutic tumor samples (p<0.01). Higher postoperative survivin levels were significantly associated with a higher ypT-stage (p<0.009), a poorer histopathologic response (p<0.01) and a shorter overall survival (p<0.028). Conclusions: The intratumoral protein expression of survivin was significantly down-regulated during neoadjuvant therapy, whereas a higher survivin level after pre-operative therapy was significantly associated with a worse histopathologic response and prognosis. Therapeutic strategies which are able to reduce survivin expression or to block survivin mediated pathways might increase the histopathologic response rate and prognosis in the multimodal therapy of patients with locally-advanced esophageal cancer. No significant financial relationships to disclose.

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