Prognostic Significance of Tumour Markers in Oesophageal Cancer
Research type
Research Study
Full title
The Relationship Between Tumour Markers and Radiological Staging Investigations in Patients with Oesophageal and Gastro-oesophageal Junction Cancer
IRAS ID
158679
Contact name
Ashley Roberts
Contact email
Sponsor organisation
Cardiff and Vale University Local Health Board
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Patients diagnosed with oesophageal cancer (OC) and gastro-oesophageal junctional (GOJ) cancer are initially staged with computed tomography (CT) of the chest and abdomen, usually following endoscopy and biopsy. This is predominately to exclude distant metastases and incurable local disease. If the patient is deemed suitable for potentially curative treatment, then endoscopic ultrasound (EUS) and positron emission tomography combined with CT (PET/CT) is performed for more detailed staging. This is the standard radiological staging pathway as recommended by the Royal College of Radiologists. [iRefer, 2013]
However, radiological staging investigations can only provide an indication of the anatomical extent of the disease at that particular time, and cannot predict the behaviour of the tumour. Novel intra-tumoural characteristics such as tumour heterogeneity, shape and texture can be measured on the staging and post neo-adjuvant therapy CT and PET/CT examinations, and have been used to predict response to treatment [Tixier et al, 2013; Yip et al, 2014]. It is hypothesised that tumours of certain heterogeneity, shape and texture have a poorer prognosis.
Specific tumour markers may provide additional valuable information regarding the tumours potential behaviour, such as the risk of spread or recurrence. This supplements traditional radiological staging, thus further informing the multi-disciplinary team's (MDT) initial management choice.
Knowledge of relevant tumour markers such as HER-2 and Ki-67 at diagnosis has been shown to predict outcome in a number of tumours such as breast cancer. [Rakovitch et al, 2012] Data regarding the use of prognostic tumour markers in OC is sparse.
CT and PET/CT tumour heterogeneity, shape and texture analysis will be performed in collaboration with computer scientists in Swansea University and Positron Emission Tomography Imaging Centre (PETIC), Cardiff. Tumour marker analysis will be performed by a Consultant Histopathologist in the University Hospital of Wales (UHW) Pathology Department.
REC name
North of Scotland Research Ethics Committee 2
REC reference
14/NS/1043
Date of REC Opinion
17 Sep 2014
REC opinion
Further Information Unfavourable Opinion