AbstractBackground and ObjectivesWe evaluated the clinicopathological associations and prognostic implications of promyelocytic leukemia gene (PML) expressions in patients with esophageal squamous cell carcinomas (ESCC) receiving primary surgery.MethodsExpression patterns of PML and tumor protein 53 (TP53) of 132 cases of ESCC were evaluated by immunohistochemistry and correlated with clinicopathological parameters. The Cox proportional hazards model was used to determine the prognostic influence of clinicopathological factors on progression‐free survival (PFS) and overall survival (OS).ResultsForty‐two cases (31.82%) were classified as lost expression of PML, 25 (18.94%) as focally positive, and 65 (49.24%) as diffusely expressed. Sixty‐three cases (47.73%) were classified as over‐expression of TP53. High expression of TP53 and down‐regulation of PML were often found in advanced disease; and, in together with high pathological staging, grading, and positive margin, were associated with poor survival. However, only tumor differentiation (P = 0.016), distant metastasis (P = 0.001), and PML expression (P = 0.001) could act as independent prognostic factors for PFS, and LN metastasis (P = 0.004), TP53 (P = 0.006), and PML expression (P = 0.029) were identified as independent prognostic factors for OS in multivariate analysis.ConclusionsOur study demonstrated PML protein as an independent prognostic marker for patients with ESCC receiving primary surgery. J. Surg. Oncol. 2011;103:761–767. © 2011 Wiley‐Liss, Inc.