The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation

Kim L. Wang, Qinghua Yang, Karen R. Cleary, Stephen G. Swisher, Arlene M. Correa, Ritsuko Komaki, Jaffer A. Ajani, Asif Rashid, Stanley R. Hamilton, Tsung Teh Wu

Research output: Contribution to journalArticle

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Abstract

BACKGROUND. Esophageal and esophagogastric junction (EGJ) adenocarcinomas frequently have neuroendocrine (NE) differentiation, but the significance of NE differentiation in patients who have undergone preoperative chemoradiation and resection remains unclear. METHODS. The authors evaluated the presence of NE differentiation in esophageal and EGJ adenocarcinomas by immunohistochemistry for chromogranin A and synaptophysin and evaluated the clinical significance of NE differentiation in 83 patients (10 patients who had a complete tumor response and 73 patients who had residual tumor in resection specimens) who received preoperative chemoradiation. RESULTS. Of 73 patients who had residual tumor after preoperative treatment, 52% showed NE differentiation. The proportion of tumor cells with NE differentiation had increased from 6% ± 18% in pretreatment biopsy specimens to 47% ± 42% (P = .00003) in posttreatment resection specimens in 30 patients who had paired pretreatment biopsy and resection specimens available. Disease-free survival (P = .002) and overall survival (P = .006) were significantly better in patients who had a complete tumor response than in patients who had residual tumor. Among patients who had residual tumor after preoperative chemoradiation, disease-free survival (P = .03) and overall survival (P = .045) were significantly better in patients who had residual tumor without NE differentiation than in patients who had residual tumor with NE differentiation. In multivariate analysis, the presence of NE differentiation in residual tumor was a prognostic factor for worse disease-free survival (P = .02) independent of pathologic stage and extent of residual tumor. CONCLUSIONS. The results from this study suggested that tumor cells with NE differentiation were more resistant to neoadjuvant chemoradiation in patients with esophageal and EGJ adenocarcinomas. The presence of NE differentiation in residual tumor was associated with poor survival after preoperative neoadjuvant therapy.

Original languageEnglish (US)
Pages (from-to)1467-1474
Number of pages8
JournalCancer
Volume107
Issue number7
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

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Esophagogastric Junction
Residual Neoplasm
Disease-Free Survival
Neuroendocrine Cells
Adenocarcinoma
Survival
Adenocarcinoma Of Esophagus
Neoplasms
Biopsy
Chromogranin A
Synaptophysin
Neoadjuvant Therapy
Multivariate Analysis

Keywords

  • Adenocarcinoma
  • Chemoradiation
  • Esophagus
  • Neuroendocrine differentiation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Wang, K. L., Yang, Q., Cleary, K. R., Swisher, S. G., Correa, A. M., Komaki, R., ... Wu, T. T. (2006). The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation. Cancer, 107(7), 1467-1474. https://doi.org/10.1002/cncr.22179

The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation. / Wang, Kim L.; Yang, Qinghua; Cleary, Karen R.; Swisher, Stephen G.; Correa, Arlene M.; Komaki, Ritsuko; Ajani, Jaffer A.; Rashid, Asif; Hamilton, Stanley R.; Wu, Tsung Teh.

In: Cancer, Vol. 107, No. 7, 01.10.2006, p. 1467-1474.

Research output: Contribution to journalArticle

Wang, KL, Yang, Q, Cleary, KR, Swisher, SG, Correa, AM, Komaki, R, Ajani, JA, Rashid, A, Hamilton, SR & Wu, TT 2006, 'The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation', Cancer, vol. 107, no. 7, pp. 1467-1474. https://doi.org/10.1002/cncr.22179
Wang, Kim L. ; Yang, Qinghua ; Cleary, Karen R. ; Swisher, Stephen G. ; Correa, Arlene M. ; Komaki, Ritsuko ; Ajani, Jaffer A. ; Rashid, Asif ; Hamilton, Stanley R. ; Wu, Tsung Teh. / The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation. In: Cancer. 2006 ; Vol. 107, No. 7. pp. 1467-1474.
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title = "The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation",
abstract = "BACKGROUND. Esophageal and esophagogastric junction (EGJ) adenocarcinomas frequently have neuroendocrine (NE) differentiation, but the significance of NE differentiation in patients who have undergone preoperative chemoradiation and resection remains unclear. METHODS. The authors evaluated the presence of NE differentiation in esophageal and EGJ adenocarcinomas by immunohistochemistry for chromogranin A and synaptophysin and evaluated the clinical significance of NE differentiation in 83 patients (10 patients who had a complete tumor response and 73 patients who had residual tumor in resection specimens) who received preoperative chemoradiation. RESULTS. Of 73 patients who had residual tumor after preoperative treatment, 52{\%} showed NE differentiation. The proportion of tumor cells with NE differentiation had increased from 6{\%} ± 18{\%} in pretreatment biopsy specimens to 47{\%} ± 42{\%} (P = .00003) in posttreatment resection specimens in 30 patients who had paired pretreatment biopsy and resection specimens available. Disease-free survival (P = .002) and overall survival (P = .006) were significantly better in patients who had a complete tumor response than in patients who had residual tumor. Among patients who had residual tumor after preoperative chemoradiation, disease-free survival (P = .03) and overall survival (P = .045) were significantly better in patients who had residual tumor without NE differentiation than in patients who had residual tumor with NE differentiation. In multivariate analysis, the presence of NE differentiation in residual tumor was a prognostic factor for worse disease-free survival (P = .02) independent of pathologic stage and extent of residual tumor. CONCLUSIONS. The results from this study suggested that tumor cells with NE differentiation were more resistant to neoadjuvant chemoradiation in patients with esophageal and EGJ adenocarcinomas. The presence of NE differentiation in residual tumor was associated with poor survival after preoperative neoadjuvant therapy.",
keywords = "Adenocarcinoma, Chemoradiation, Esophagus, Neuroendocrine differentiation",
author = "Wang, {Kim L.} and Qinghua Yang and Cleary, {Karen R.} and Swisher, {Stephen G.} and Correa, {Arlene M.} and Ritsuko Komaki and Ajani, {Jaffer A.} and Asif Rashid and Hamilton, {Stanley R.} and Wu, {Tsung Teh}",
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T1 - The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation

AU - Wang, Kim L.

AU - Yang, Qinghua

AU - Cleary, Karen R.

AU - Swisher, Stephen G.

AU - Correa, Arlene M.

AU - Komaki, Ritsuko

AU - Ajani, Jaffer A.

AU - Rashid, Asif

AU - Hamilton, Stanley R.

AU - Wu, Tsung Teh

PY - 2006/10/1

Y1 - 2006/10/1

N2 - BACKGROUND. Esophageal and esophagogastric junction (EGJ) adenocarcinomas frequently have neuroendocrine (NE) differentiation, but the significance of NE differentiation in patients who have undergone preoperative chemoradiation and resection remains unclear. METHODS. The authors evaluated the presence of NE differentiation in esophageal and EGJ adenocarcinomas by immunohistochemistry for chromogranin A and synaptophysin and evaluated the clinical significance of NE differentiation in 83 patients (10 patients who had a complete tumor response and 73 patients who had residual tumor in resection specimens) who received preoperative chemoradiation. RESULTS. Of 73 patients who had residual tumor after preoperative treatment, 52% showed NE differentiation. The proportion of tumor cells with NE differentiation had increased from 6% ± 18% in pretreatment biopsy specimens to 47% ± 42% (P = .00003) in posttreatment resection specimens in 30 patients who had paired pretreatment biopsy and resection specimens available. Disease-free survival (P = .002) and overall survival (P = .006) were significantly better in patients who had a complete tumor response than in patients who had residual tumor. Among patients who had residual tumor after preoperative chemoradiation, disease-free survival (P = .03) and overall survival (P = .045) were significantly better in patients who had residual tumor without NE differentiation than in patients who had residual tumor with NE differentiation. In multivariate analysis, the presence of NE differentiation in residual tumor was a prognostic factor for worse disease-free survival (P = .02) independent of pathologic stage and extent of residual tumor. CONCLUSIONS. The results from this study suggested that tumor cells with NE differentiation were more resistant to neoadjuvant chemoradiation in patients with esophageal and EGJ adenocarcinomas. The presence of NE differentiation in residual tumor was associated with poor survival after preoperative neoadjuvant therapy.

AB - BACKGROUND. Esophageal and esophagogastric junction (EGJ) adenocarcinomas frequently have neuroendocrine (NE) differentiation, but the significance of NE differentiation in patients who have undergone preoperative chemoradiation and resection remains unclear. METHODS. The authors evaluated the presence of NE differentiation in esophageal and EGJ adenocarcinomas by immunohistochemistry for chromogranin A and synaptophysin and evaluated the clinical significance of NE differentiation in 83 patients (10 patients who had a complete tumor response and 73 patients who had residual tumor in resection specimens) who received preoperative chemoradiation. RESULTS. Of 73 patients who had residual tumor after preoperative treatment, 52% showed NE differentiation. The proportion of tumor cells with NE differentiation had increased from 6% ± 18% in pretreatment biopsy specimens to 47% ± 42% (P = .00003) in posttreatment resection specimens in 30 patients who had paired pretreatment biopsy and resection specimens available. Disease-free survival (P = .002) and overall survival (P = .006) were significantly better in patients who had a complete tumor response than in patients who had residual tumor. Among patients who had residual tumor after preoperative chemoradiation, disease-free survival (P = .03) and overall survival (P = .045) were significantly better in patients who had residual tumor without NE differentiation than in patients who had residual tumor with NE differentiation. In multivariate analysis, the presence of NE differentiation in residual tumor was a prognostic factor for worse disease-free survival (P = .02) independent of pathologic stage and extent of residual tumor. CONCLUSIONS. The results from this study suggested that tumor cells with NE differentiation were more resistant to neoadjuvant chemoradiation in patients with esophageal and EGJ adenocarcinomas. The presence of NE differentiation in residual tumor was associated with poor survival after preoperative neoadjuvant therapy.

KW - Adenocarcinoma

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