| Summary: | 博士 === 長庚大學 === 臨床醫學研究所 === 99 === Carcinoma of the esophagus is a highly malignant cancer and generally carries a poor prognosis. Five year survival is less than 25% even after complete surgical removal. In order to improve resectability and reduce distant metastases, the combination of chemotherapy, radiotherapy and surgery had been introduced since 1995. Recent one metaanalysis confirmed the benefit of increasing locoregional control after such strategy, especially in squamous cell carcinoma(SCC) subtype. However, the benefit of neoadjuvant CRT in reducing distant recurrence is still questionable. Many patients had excellent local control after CRT+surgery but died with distant recurrence ultimately.
After the impact of CRT, accurate restaging of patients after resection is important because it provides prognostic information. However, using the current staging criteria for prognosis stratification after CRT had been challenged in recent years. Though several prognostic markers after CRT had been identified, most of them were focused on adenocarcinoma, which was different from our predominant SCC group.
Our project comprised one cell-line based and three clinical translational studies.
Firstly, we identified Podoplanin and phosphorylated 4E-binding protein 1 as good prognosticators in post-CRT residual tumor tissue. We also identified the existence of lymph node micrometases as significant poor prognosticators after pathological complete response. Secondly, one epithelial-mesenchymal transition related marker: Transketolase was identified from cell line based approach and correlated with clinical findings.
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