Caspase-3 expression in metastatic lymph nodes of esophageal squamous cell carcinoma is prognostic of survival

Table 1 Demographic and clinicopathologic characteristics of the patient cohort

Characteristic	n (%)
Age at diagnosis (yr)
≤ 58	61 (50)
> 58	61 (50)
Gender
Male	102 (83.6)
Female	20 (16.4)
Surgical approach1
Sweet	58 (47.5)
McKeown	64 (52.5)
Tumor location
Upper	13 (10.6)
Middle	69 (56.6)
Lower	40 (32.8)
Tumor grade
G1	28 (22.9)
G2	59 (48.4)
G3	35 (28.7)
pT category
T2	12 (9.8)
T3	103 (84.4)
T4a2	7 (5.7)
pN category
N1	64 (52.5)
N2	45 (36.9)
N3	13 (10.6)

¹The sweet procedure consists of esophagectomy with standard dissection of thoracic and abdominal lymph nodes through left thoracotomy; the McKeown procedure consists of esophagectomy with extended dissection of thoracic and abdominal lymph nodes through thoracic-abdominal-cervical incision;

²T4a, resectable tumor invading pleura (n = 4), pericardium (n = 1), and diaphragm (n = 2).

Table 2 Correlations between caspase-3 protein expression and clinicopathologic features

Characteristic	Number of patients	Caspase-3 expression in PT		Caspase-3 expression in PMLN
		Mean rank	P value1	Mean rank	P value1
Gender
Male	102	60.22	0.365	63.18	0.237
Female	20	68.05		52.95
Age (yr)
≤ 58	61	62.23	0.820	63.1	0.617
> 58	61	60.77		59.9
Tumor location
Upper/middle	82	62.27	0.731	64.76	0.145
Lower	40	59.92		54.82
Tumor grade
G1	28	66.11	0.432	55.32	0.292
G2/G3	94	60.13		63.34
pT category
T2	12	103.7	< 0.001	84.92	0.016
T3/T4a	110	56.9		58.95
LN metastases2
N1	64	62.36	0.778	58.23	0.283
N2/N3	58	60.55		65.11

¹Mann-Whitney U-test;

²Number of involved lymph nodes. PT: Primary tumors; PMLN: Paired metastatic lymph nodes.

Table 3 Disease-specific survival analyses according to caspase-3 expression in primary esophageal squamous cell carcinoma and paired metastatic lymph nodes

Characteristic	Number of patients	Disease-specific survival (mo)		P value1
		Mean	Median
Expression in PT
Negative	34	22	21	0.033
Positive	88	39	23
Expression in PT
Low level	68	32	21	0.586
High level	54	37	19
Expression in PMLN
Negative	6	81	NR	0.0172
Positive	116	32	21
Expression in PMLN
Low level	28	48	22	0.043
High level	94	30	20

¹Kaplan-Meier method (log-rank test);

²The results were uncertain, due to few patients in the negative subgroup. PT: Primary tumors; NR: Not reached; PMLN: Paired metastatic lymph nodes.

Table 4 Univariate and multivariate analyses1 of factors associated with disease-specific survival in 122 patients with esophageal squamous cell carcinoma

Prognostic factor	P value	RR	95%CI
Univariate survival analysis
Gender (male vs female)	0.91	1.031	0.611-1.740
Age ( ≤ 58 vs > 58)	0.012	1.661	1.118-2.469
Location(lower vs upper/middle)	0.293	0.877	0.687-1.120
Differentiation (grade 1 vs grade 2/3)	0.051	1.623	0.998-2.641
Surgical approach (Sweet vs McKeown)	0.637	0.91	0.615-1.347
Adjuvant therapy (No vs Yes)	0.501	0.907	0.683-1.205
pT category (T2 vs T3/T4a)	0.61	1.186	0.616-2.285
pN category (N1 vs N2/N3)	< 0.001	2.19	1.463-3.277
Caspase-3 expression in PT	0.037	0.627	0.404-0.973
(negative vs positive)
Caspase-3 expression in PMLN	0.03	4.909	1.164-20.708
(low vs high level expression)
Multivariate survival analysis
Age ( ≤ 58 vs > 58)	< 0.001	2.122	1.404-3.207
pN category (N1 vs N2/N3)	< 0.001	2.422	1.590-3.690
Caspase-3 expression in PT	0.021	0.584	0.370-0.921
(negative vs positive)
Caspase-3 expression in PMLN	0.01	1.991	1.180-3.359
(low vs high level)

¹Cox proportional hazards regression analysis (Forward stepwise); RR: Relative risk; PT: Primary tumor; PMLN: Paired metastatic lymph node.