Bite-on-bite biopsies for the detection of residual esophageal cancer after neoadjuvant chemoradiotherapy.

Autor:	van der Bogt RD; Department of Gastroenterology and Hepatology, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., van der Wilk BJ; Department of Surgery, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Oudijk L; Department of Pathology, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Schoon EJ; Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, The Netherlands.; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands., van Lijnschoten G; Department of Pathology, Stichting PAMM, Eindhoven, The Netherlands., Corporaal S; Department of Gastroenterology and Hepatology, Leeuwarden Medical Center, Leeuwarden, The Netherlands., Nieken J; Department of Pathology, Pathology Friesland, Leeuwarden, The Netherlands., Siersema PD; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands., Bisseling TM; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands., van der Post RS; Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands., Quispel R; Department of Gastroenterology and Hepatology, Reinier de Graaf Hospital, Delft, The Netherlands., van Tilburg A; Department of Pathology, Reinier de Graaf Hospital, Delft, The Netherlands., Oostenbrug LE; Department of Gastroenterology and Hepatology, Zuyderland Medical Center, Heerlen, The Netherlands., Riedl RG; Department of Pathology, Zuyderland Medical Center, Heerlen, The Netherlands., Hol L; Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, The Netherlands., Kliffen M; Department of Pathology, Maasstad Hospital, Rotterdam, The Netherlands., Nikkessen S; Department of Gastroenterology and Hepatology, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Eyck BM; Department of Surgery, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., van Lanschot JJB; Department of Surgery, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Doukas M; Department of Pathology, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Spaander MCW; Department of Gastroenterology and Hepatology, Erasmus Cancer Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Endoscopy [Endoscopy] 2022 Dec; Vol. 54 (12), pp. 1131-1138. Date of Electronic Publication: 2022 Jun 03.
DOI:	10.1055/a-1846-1025
Abstrakt:	Background: Active surveillance after neoadjuvant treatment is increasingly implemented. The success of this strategy relies on the accurate detection of residual cancer. This study aimed to assess the diagnostic value of a second (bite-on-bite) biopsy for the detection of residual esophageal cancer and to correlate outcomes to the distribution of residual cancer found in the resection specimen. Methods: A multicenter prospective study of esophageal cancer patients undergoing active surveillance after neoadjuvant chemoradiotherapy was performed. At clinical response evaluations, an upper gastrointestinal (GI) endoscopy was performed with at least four bite-on-bite biopsies of the primary tumor site. First and second biopsies were analyzed separately. Patients with histopathological evidence of residual cancer were included in the primary analysis. Two pathologists blinded for biopsy outcome examined all resection specimens. Results: Between October 2017 and July 2020, 626 upper GI endoscopies were performed in 367 patients. Of 138 patients with residual cancer, 112 patients (81 %) had at least one positive biopsy. In 14 patients (10 %) only the first biopsy was positive and in 25 patients (18 %) only the second biopsy ( P  = 0.11). Remarkably, the rates of patients with tumor-free mucosa and deeper located tumors were higher in patients detected by the first biopsy. The second biopsy increased the false-positive rate by 3 percentage points. No adverse events occurred. Conclusions: A second (bite-on-bite) biopsy improves the detection of residual esophageal cancer by almost 20 percentage points, at the expense of increasing the false-positive rate by 3 percentage points. The higher detection rate is explained by the higher number of biopsies obtained rather than by the penetration depth. Competing Interests: P.D. Siersema has received research support from Pentax, The E-Nose Company, MicroTech, and Motus GI, and consultation fees from Boston Scientific and Motus GI. J.J.B van Lanschot has received research support from the Dutch Cancer Society and ZonMW. The remaining authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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