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The prognosis for patients with esophageal and esophagogastric junction (EGJ) adenocarcinoma remains poor, even after surgical resection. Pathologic assessment of depth of invasion and lymph node status are the primary prognostic factors in these patients. In patients with esophageal squamous cell carcinoma, increased epidermal growth factor receptor (EGFR) expression has been associated with a worse prognosis. It is not known whether EGFR plays a similar role in esophageal and EGJ adenocarcinomas.To address this issue, the authors studied tumor specimens from 103 patients with surgically resected esophageal and EGJ adenocarcinomas (9 patients with stage I disease, 23 patients with stage II disease, 57 patients with stage III disease, and 14 patients with stage IV disease). The expression of EGFR was assessed by immunohistochemical analysis of tissue microarrays. Tumors were considered positive for EGFR expression when >5% of tumor cells were stained and negative when ≤5% of tumor cells were stained.EGFR was expressed in 33 of 103 adenocarcinomas (32%) and was correlated with higher pathologic tumor (T) classification (P = .02), the presence of lymph node metastasis (P = .01), and higher pathologic tumor, lymph node, metastasis classification (P = .02). EGFR expression also was correlated with shorter disease‐free and overall survival in univariate analyses (P = .001 and P = .004, respectively), and there was a trend toward a correlation between EGFR expression and shorter disease‐free survival in multivariate analyses (P = .07 and P = .08). The results demonstrated that EGFR expression in esophageal adenocarcinomas was correlated with advanced pathologic tumor classification and lymph node metastasis. EGFR expression also was correlated with poor disease‐free and overall survival, but that correlation was not independent of T classification.The current findings suggested that EGFR expression correlates with poor prognostic factors and may be used to predict patient outcomes. Cancer 2007. © 2007 American Cancer Society. [ABSTRACT FROM AUTHOR]

The objective of the study was to determine the utility of integrated computed tomography / positron emission tomography (CT‐PET) imaging for detecting interval distant metastases and assessing therapeutic response in patients with locally advanced, potentially resectable esophageal carcinoma after neoadjuvant therapy.A retrospective study was performed of 88 patients with potentially resectable esophageal carcinoma who received neoadjuvant therapy before planned surgical resection. CT‐PET before and after completion of neoadjuvant was used for evaluating therapeutic response; response criteria were based on qualitative and semiquantitative analyses.Neoadjuvant therapy comprised chemoradiotherapy in 85 patients, with prior induction chemotherapy in 39 patients. Fifty‐five patients proceeded to esophagectomy. Repeat CT‐PET was performed after induction chemotherapy (n = 23) and after completing chemoradiotherapy (n = 85). CT‐PET identified the interval appearance of metastatic disease in 7 (8%) patients. For assessment of locoregional therapeutic response, CT‐PET was unable to predict pathological response to neoadjuvant therapy in the primary tumor or locoregional lymph nodes. CT‐PET had sensitivity, specificity, and positive and negative predictive values of 57%, 46%, 39%, and 64%, respectively, for detection of residual macroscopic malignancy within the primary tumor; and sensitivity, specificity, and positive and negative predictive values of 0%, 90%, 0%, and 69% for detection of residual malignancy within resected lymph nodes.CT‐PET performed after neoadjuvant therapy in patients with potentially resectable esophageal carcinoma is important for detecting interval metastases that preclude surgical resection, but is of limited utility for assessing locoregional therapeutic response. Cancer 2007. © 2006 American Cancer Society [ABSTRACT FROM AUTHOR]