Brief Article
Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Oncol. May 15, 2012; 4(5): 103-108
Published online May 15, 2012. doi: 10.4251/wjgo.v4.i5.103
Relationship between HER-2 overexpression and brain metastasis in esophageal cancer patients
Taher Abu Hejleh, Barry R DeYoung, Eric Engelman, Jeremy M Deutsch, Bridget Zimmerman, Thorvardur R Halfdanarson, Daniel J Berg, Kalpaj R Parekh, William R Lynch, Mark D Iannettoni, Sudershan Bhatia, Gerald Clamon
Taher Abu Hejleh, Eric Engelman, Jeremy M Deutsch, Thorvardur R Halfdanarson, Daniel J Berg, Gerald Clamon, Division of Hematology, Oncology and Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, C32 GH, Iowa City, IA 52242-1081, United States
Barry R DeYoung, Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 5238C RCP, Iowa City, IA 52242-1081, United States
Bridget Zimmerman, Department of Biostatistics, College of Public Health, University of Iowa, 200 Hawkins Drive, N377 CPHB, Iowa City, IA 52242-1081, United States
Kalpaj R Parekh, William R Lynch, Mark D Iannettoni, Department of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, SE514 GH, Iowa City, IA 52242-1081, United States
Sudershan Bhatia, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 1624 PFP, Iowa City, IA 52242-1081, United States
Author contributions: Abu Hejleh T performed most of the work, including study design, data collection, analyzing the study results, and writing the manuscript; Engelman E and Deutsch JM participated in designing the study, data collection and editing the manuscript; Halfdanarson TR, Berg DJ and Clamon G participated in the study design, analyzing the results and editing the manuscript; DeYoung BR was involved in the study design, performed the immunohistochemistry stains for HER-2, and edited the manuscript; Zimmerman B addressed the study design, performed the statistical analysis and approved the results included in the final manuscript; Parekh KR, Lynch WR and Iannettoni MD were involved in the study concept and design, performed the surgeries (esophagectomies), edited and approved the final manuscript; Bhatia S participated in the study design, supervised radiation delivery to the esophagus, and edited the final manuscript; all authors approved the final manuscript for publication.
Supported by The Iowa Leukemia and Cancer Research Fund at University of Iowa Hospitals and clinics
Correspondence to: Taher Abu Hejleh, MBBS, Division of Hematology, Oncology and Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr. C32 GH, Iowa City, IA52242-1081, United States. taher-hejleh@uiowa.edu
Telephone: +1-319-6217975 Fax: +1-319-3538383
Received: October 1, 2011
Revised: January 19, 2012
Accepted: March 10, 2012
Published online: May 15, 2012
Abstract

AIM: To study if HER-2 overexpression by locally advanced esophageal cancers increase the chance of brain metastasis following esophagectomy.

METHODS: We retrospectively reviewed the medical records of esophageal cancer patients who underwent esophagectomy at University of Iowa Hospitals and Clinics between 2000 and 2010. Data analyzed consisted of demographic and clinical variables. The brain metastasis tissue was assayed for HER-2 overexpression utilizing the FDA approved DAKO Hercept Test®.

RESULTS: One hundred and forty two patients were reviewed. Median age was 64 years (36-86 years). Eighty eight patients (62%) received neoadjuvant chemoradiotherapy. Pathological complete and partial responses were achieved in 17 (19%) and 71 (81%) patients. Cancer relapsed in 43/142 (30%) patients. The brain was the first site of relapse in 9/43 patients (21%, 95% CI: 10%-36%). HER-2 immunohistochemistry testing of the brain metastasis tissue showed that 5/9 (56%) cases overexpressed HER-2 (3+ staining).

CONCLUSION: HER-2 overexpression might be associated with increased risk of brain metastasis in esophageal cancer patients following esophagectomy. Further studies will be required to validate this observation.

Keywords: Esophageal neoplasm; Esophageal cancer; HER-2; Genes, erbB-2; Brain Neoplasms; Brain metastasis