Clinicopathologic factors predicting complete pathological response to neoadjuvant chemoradiotherapy in esophageal cancer
Multimodal therapy comprising neoadjuvant chemotherapy and radiation therapy prior to radical resection is increasingly utilized in gastroesophageal cancer. The achievement of a complete pathological response (pCR) or a major response is associated with an improved survival. However, up to 70% of pa...
Saved in:
Published in: | Diseases of the esophagus Vol. 19; no. 4; pp. 273 - 276 |
---|---|
Main Authors: | , , , , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
Melbourne, Australia
Blackwell Publishing Asia
01-08-2006
|
Subjects: | |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Multimodal therapy comprising neoadjuvant chemotherapy and radiation therapy prior to radical resection is increasingly utilized in gastroesophageal cancer. The achievement of a complete pathological response (pCR) or a major response is associated with an improved survival. However, up to 70% of patients show an incomplete or no response to the neoadjuvant regimen, and the identification of factors which predict a response would be of considerable clinical benefit. A retrospective analysis of a prospectively updated esophageal cancer database was performed. The predictive values of the following clinicopathological factors were investigated: age, sex, tobacco, alcohol, weight, clinical history, tumor type, site, length, width, morphology and differentiation. Statistical analysis was performed using Chi‐square test with Pearson's test or Kruskal–Wallis test. One hundred and seventy‐six patients were identified who had undergone neo‐adjuvant chemoradiotherapy at St James's Hospital Dublin, between January 1990 and June 2003. A complete pathological response was seen in 40 cases (23%). There was a significant (P < 0.05) relationship between response to chemoradiotherapy and pretreatment tumor length. The median tumor length in the pCR group was 2 cm (1–5 cm) compared with 3 cm (2–7 cm) in non‐responders (P < 0.05). Body weight, sex, tobacco or alcohol usage, tumor site, or differentiation were not predictive of response, although a trend (P = 0.08) was observed for squamous cell cancer compared with adenocarcinoma. Smaller tumor length was predictive of a greater response to chemotherapy and radiation therapy. This may reflect different tumor biology, perhaps with acquired resistance to treatment‐induced apoptosis in the larger tumors. A simpler explanation is that the existing dose and treatment schedule for combination chemoradiotherapy is suboptimal in patients with larger tumors. |
---|---|
Bibliography: | istex:54C988586061D40F4E2D45F52D22D9322AEEE49B ArticleID:DOTE576 ark:/67375/WNG-XDM9L3ZQ-X ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1120-8694 1442-2050 |
DOI: | 10.1111/j.1442-2050.2006.00576.x |