Prognostic significance of lymphocyte infiltration following preoperative chemoradiotherapy and hyperthermia for esophageal cancer

• Published in: International journal of radiation oncology, biology, physics Vol. 49; no. 5; pp. 1259 - 1266
• Main Authors: Morita, Masaru, Kuwano, Hiroyuki, Araki, Kohshi, Egashira, Akinori, Kawaguchi, Hidetoshi, Saeki, Hiroshi, Kitamura, Kaoru, Ohno, Shinji, Sugimachi, Keizo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2001; Elsevier
• Subjects: Analysis of Variance; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bleomycin - administration & dosage; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - immunology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Cisplatin - administration & dosage; Combined Modality Therapy; Diseases of the digestive system; Esophageal cancer; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - immunology; Esophageal Neoplasms - pathology; Esophageal Neoplasms - radiotherapy; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hyperthermia; Hyperthermia, Induced; Immunity, Cellular; Lymphocyte infiltration; Lymphocytes, Tumor-Infiltrating - physiology; Male; Medical sciences; Middle Aged; Neoplasm Staging; Prognosis; Radiation; Radiotherapy Dosage; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Regression Analysis; Survival Rate; Tumors; Hyperthermia; Lymphocyte infiltration; Esophageal cancer; Radiation; Human; Prognosis; Esophageal disease; Stage classification; Thermotherapy; Malignant tumor; Chemoradiotherapy; Epidemiology; Incidence; Esophagus; Pathology; Digestive diseases; Infiltration; Preoperative; Lymphocyte
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/S0360-3016(00)01465-6

Purpose: Lymphocyte infiltration (LI) around cancerous lesions is an important immune response. The purpose of this study is to evaluate the prognostic significance of LI after preoperative treatment for esophageal cancer. Methods and Materials: Preoperative chemoradiotherapy (CR therapy), either bleomycin 30 mg or cisplatin 120 mg/m 2 plus radiation 30 Gy, was performed on 51 cases with esophageal cancer, while hyperthermo-chemoradiotherapy (HCR therapy) was also indicated in 71 cases. Using resected specimens, both the histopathologic effectiveness and degree of LI to cancerous lesions were evaluated. Results: The incidences of the cases in which preoperative treatment was effective were 56% and 92.3% in LI (−) and LI (++) group ( p < 0.05). The presence of LI resulted in favorable prognosis; the 5-year survival rates of LI (++) and LI (+) patients were 75.5% and 46.1%, both of which were significantly better than LI (−) (27.8%, p < 0.05 and p < 0.01, respectively). Especially among cases whose preoperative treatment was moderately effective, a multivariate analysis revealed LI to be a favorable prognostic factor independent of other clinicopathologic factors ( p = 0.0171). Regarding the preoperative treatment, the incidence of LI (++) was higher in the HCR group (16.9%) than in the CR group (2.0%, p < 0.01). Conclusions: LI appears to be a prognostic predictor after preoperative CR therapy while, in addition, simultaneous hyperthermia may stimulate LI in cases with esophageal cancer.