Expression of epidermal growth factor receptor in esophageal and esophagogastric junction adenocarcinomas - Association with poor outcome

BACKGROUND. 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. METHODS. 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 11 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. RESULTS. 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. CONCLUSIONS. The current findings suggested that EGFR expression correlates with poor prognostic factors and may be used to predict patient outcomes.