HER‐2 status in primary oesophageal cancer, lymph nodes and distant metastases

Author: S. F. Schoppmann, B. Jesch, J. Zacherl, F. Wrba, M. Hejna, J. Maresch, F. B. Langer, M. F. Riegler, U. Pluschnig, P. Birner

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Sir,

Schoppmann and colleagues have shown that the concordance between HER-2 status at the primary tumour and other sites is high at over 85 per cent, and therefore discourage the routine HER-2 testing of metastases.

This cohort study over a 17-year period at a large university hospital reviewed 176 patients with oesophageal cancer who had undergone curative resection. HER-2 status was determined retrospectively on these patients who were deemed to have ‘sufficient tumour for analysis’. However, the number of patients excluded from analysis due to insufficient samples was not mentioned. Was this due to the degeneration of tissue samples over time or due to patients demonstrating a complete pathological response following neoadjuvant chemotherapy?

This selection bias could have led to a relatively low HER-2 positive rate in this study (14 per cent in adenocarcinoma and 1 per cent in squamous cell carcinoma; cf. 23 - 30 per cent and 13 - 26 per cent respectively [1,2]) and perhaps a higher concordance rate.

Yours sincerely,

DSY Chan, AJ Beamish
University Hospital of Wales, Cardiff
Dcsy23@gmail.com

References

1. Hardwick RH, Barham CP, Ozua P, Newcomb PV, Savage P, Powell R, Rahamin J, Alderson D. Immunohistochemical detection of p53 and c-erbB-2 in oesophageal carcinoma; no correlation with prognosis. Eur J Surg Oncol 1997; 23: 30-35.

2. Dreilich M, Wanders A, Brattstrom D, Bergstrom S, Hesselius P, Wagenius G, Bergqvist M. HER-2 overexpression (3+) in patients with squamous cell esophageal carcinoma correlates with poorer survival. Dis Esophagus 2006; 19: 224-231.