BACKGROUND: Reports are limited regarding clinical and pretreatment features that might predict a pathological complete response (pathCR) after treatment in patients with esophageal cancer (EC). This might allow patient selection for different strategies. This study examines the association of a pathCR with pretreatment variables, overall survival (OS), recurrence-free survival (RFS), and patterns of recurrence in a large cohort from a single institution. METHODS: The baseline clinical features of 911 consecutive patients with EC who were treated with trimodality therapy from January 2000 to November 2013 were analyzed. A pathCR was defined as a surgical specimen with no residual carcinoma (primary or nodes). Logistic regressions were used to identify independent baseline features associated with a pathCR. We applied log-rank testing and Cox models to determine the association between a pathCR and the time-to-event outcomes (OS and RFS). RESULTS: Of 911 patients, 218 (23.9%) achieved a pathCR. The pathCR rate was 23.1% for adenocarcinoma and 32.2% for squamous cell carcinoma. A lower pathCR rate was observed for 1) older patients (>60 years), 2) patients with poorly differentiated tumors, 3) patients with signet ring cells (SRCs), and 4) patients with a higher T stage. Patients with a pathCR had longer OS and RFS than those without a pathCR (P = .0021 and P = .0011, respectively). Recurrences occurred more in non-pathCR patients. Distant metastases were the most common type of recurrence. PathCR patients developed brain metastases at a marginally higher rate than non-pathCR patients (P = .051). CONCLUSIONS: In this large cohort study, a pathCR is confirmed to be associated with better OS and RFS. The presence of a poorly differentiated tumor or SRCs reduces the likelihood of a pathCR. Future research should focus on molecular classifiers. Cancer 2017;123:4106-4113.
BACKGROUND: Reports are limited regarding clinical and pretreatment features that might predict a pathological complete response (pathCR) after treatment in patients with esophageal cancer (EC). This might allow patient selection for different strategies. This study examines the association of a pathCR with pretreatment variables, overall survival (OS), recurrence-free survival (RFS), and patterns of recurrence in a large cohort from a single institution. METHODS: The baseline clinical features of 911 consecutive patients with EC who were treated with trimodality therapy from January 2000 to November 2013 were analyzed. A pathCR was defined as a surgical specimen with no residual carcinoma (primary or nodes). Logistic regressions were used to identify independent baseline features associated with a pathCR. We applied log-rank testing and Cox models to determine the association between a pathCR and the time-to-event outcomes (OS and RFS). RESULTS: Of 911 patients, 218 (23.9%) achieved a pathCR. The pathCR rate was 23.1% for adenocarcinoma and 32.2% for squamous cell carcinoma. A lower pathCR rate was observed for 1) older patients (>60 years), 2) patients with poorly differentiated tumors, 3) patients with signet ring cells (SRCs), and 4) patients with a higher T stage. Patients with a pathCR had longer OS and RFS than those without a pathCR (P = .0021 and P = .0011, respectively). Recurrences occurred more in non-pathCR patients. Distant metastases were the most common type of recurrence. PathCR patients developed brain metastases at a marginally higher rate than non-pathCR patients (P = .051). CONCLUSIONS: In this large cohort study, a pathCR is confirmed to be associated with better OS and RFS. The presence of a poorly differentiated tumor or SRCs reduces the likelihood of a pathCR. Future research should focus on molecular classifiers. Cancer 2017;123:4106-4113.
Authors: Arianna Barbetta; Tamar B Nobel; Smita Sihag; Meier Hsu; Kay See Tan; Manjit S Bains; James M Isbell; Yelena Y Janjigian; Abraham J Wu; Matthew J Bott; David R Jones; Daniela Molena Journal: Ann Thorac Surg Date: 2018-05-05 Impact factor: 4.330
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Authors: Theodore S Hong; Eliezer M Van Allen; Sophia C Kamran; Jochen K Lennerz; Claire A Margolis; David Liu; Brendan Reardon; Stephanie A Wankowicz; Emily E Van Seventer; Adam Tracy; Jennifer Y Wo; Scott L Carter; Henning Willers; Ryan B Corcoran Journal: Clin Cancer Res Date: 2019-06-28 Impact factor: 12.531
Authors: Brett S Walker; Thomas L Sutton; Luai Zarour; John G Hunter; Stephanie G Wood; V Liana Tsikitis; Daniel O Herzig; Charles D Lopez; Emerson Y Chen; Skye C Mayo; Melissa H Wong Journal: Ann Surg Oncol Date: 2021-08-07 Impact factor: 5.344
Authors: Helena Hong Wang; Ellen C de Heer; Jan Binne Hulshoff; Gursah Kats-Ugurlu; Johannes G M Burgerhof; Boudewijn van Etten; John Th M Plukker; Geke A P Hospers Journal: Ann Surg Oncol Date: 2020-11-28 Impact factor: 5.344