演題番号 : P70-4
Previous study showed that perioperative changes of serum p53 antibody (s-p53-Abs) titer may be a useful marker to identify high-risk patients for tumor recurrence. However, association of changes of s-p53-Abs titer, particularly after neoadjuvant therapy followed by surgery, with postoperative tumor recurrence risk in patients with esophageal cancer is little known.
A total of 64 consecutive esophageal cancer patients, who underwent neoadjuvant therapy followed by radical esophagectomy in Shizuoka Cancer Center between 2013 and 2016, were analyzed s-p53-Abs titer. Eighteen (28%) of 64 patients were positive for s-p53-Abs before treatment. The cut-off level of 1.3 U/ml was used to indicate seropositive patients. Impact of changes of s-p53-Abs titer by treatment on postoperative recurrence was evaluated.
Initial clinical stage; II/III/IV(LYM#104) (UICC 7th), 4/13/1. Pathological stage; 0/I/II/III/IV(LYM#104), 1/2/3/10/2. In 12 (67%) of 18 patients, the s-p53-Abs decreased less than 50% (<50%) after treatment (Group I). In 3 patients (17%), it decreased <100%, >50% after treatment (Group II). In 3 patients (17%), it increased (>100%) after treatment (Group III). Among seropositive patients, Group I showed significantly better recurrence free survival than Group II or Group III (p<0.01). Group II showed better recurrence free survival than Group III (p=0.022). In Group III, they all relapsed within 4 months. Five patients (27%) in Group I showed negative conversion in the post-treatment course and they all did not relapse for at least 1 year (377-1204 days).
In our study, the increase of s-p53-Ab titer after treatment might be useful to identify esophageal cancer patients with a high risk of tumor recurrence. The patients who showed negative conversion had a low risk of tumor recurrence.