Annals of Surgical Oncology

, Volume 13, Issue 12, pp 1724–1731 | Cite as

REG I Expression Predicts Long-term Survival among Locally Advanced Thoracic Squamous Cell Esophageal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy Followed by Esophagectomy

  • Satoru Motoyama
  • Toshihiro Sugiyama
  • Yasuharu Ueno
  • Hiroshi Okamoto
  • Shin Takasawa
  • Hiroshi Nanjo
  • Hitoshi Watanabe
  • Kiyotomi Maruyama
  • Manabu Okuyama
  • Jun-ichi Ogawa



The prognosis for patients with locally advanced thoracic esophageal cancer is extremely unfavorable. We have been administering neoadjuvant chemoradiotherapy (CRT) followed by esophagectomy to these patients and studying whether REG I expression in untreated endoscopic biopsy specimens is predictive of patient responsiveness to CRT and/or survival after treatment.


Between 1992 and 2003, 47 patients with T4 (direct invasion of adjacent organs) thoracic esophageal cancers were administered neoadjuvant CRT followed by esophagectomy. REG I expression was assessed in untreated endoscopic biopsy specimens and correlated with clinical and histological responses and survival in 37 patients who had also undergone curative surgery.


Among the 37 cases that received CRT followed by surgery, the therapeutic response rate for neoadjuvant CRT was 68%, and a complete histological response in resected specimens from the primary lesion was achieved in 8 (22%) patients. These clinical and histological responses to neoadjuvant CRT did not significantly correlate with survival, however. By contrast, 9 patients were judged REG-positive based on analysis of their untreated endoscopic biopsy specimens, and their cumulative survival rate was significantly higher than that of the 28 REG-negative patients (P = 0.0073). Univariate analysis showed REG I expression to be a prognostic factor (P = 0.0386) that increased the risk of death 8.4-fold.


Evaluation of REG I expression in untreated endoscopic biopsy specimens may provide a basis for new treatments of locally advanced thoracic squamous cell esophageal cancers.


Esophageal cancer Chemoradiotherapy Esophagectomy REG I Prognosis 


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Copyright information

© Society of Surgical Oncology 2006

Authors and Affiliations

  • Satoru Motoyama
    • 1
  • Toshihiro Sugiyama
    • 2
  • Yasuharu Ueno
    • 2
  • Hiroshi Okamoto
    • 3
  • Shin Takasawa
    • 4
  • Hiroshi Nanjo
    • 5
  • Hitoshi Watanabe
    • 6
  • Kiyotomi Maruyama
    • 1
  • Manabu Okuyama
    • 1
  • Jun-ichi Ogawa
    • 1
  1. 1.Department of SurgeryAkita University School of MedicineAkitaJapan
  2. 2.Department of BiochemistryAkita University School of MedicineAkitaJapan
  3. 3.Department of Advanced Biological Sciences for Regeneration (Kotobiken Medical Laboratories)Tohoku University Graduate School of MedicineSendaiJapan
  4. 4.Department of BiochemistryTohoku University Graduate School of MedicineSendaiJapan
  5. 5.Department of PathologyAkita University School of MedicineAkitaJapan
  6. 6.Central Research LaboratoryAkita University School of MedicineAkitaJapan

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