Impact of response evaluation for resectable esophageal adenocarcinoma – A retrospective cohort study
| Autor: | Robert Bachmann, Ruth Ladurner, Jeannine Bachmann, G. Sitzmann, A. Hungbauer, Alfred Königsrainer, J. Schmehl |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Oncology medicine.medical_specialty Esophageal Neoplasms Adenocarcinoma Prognostic factors Neoadjuvant chemotherapy Cohort Studies Gastrectomy Internal medicine medicine Carcinoma Humans Stage (cooking) Aged Retrospective Studies Tumor Regression Grade Univariate analysis business.industry Standard treatment Anastomosis Surgical Retrospective cohort study General Medicine Histopathological regression grading Middle Aged Esophageal cancer Prognosis medicine.disease Neoadjuvant Therapy Esophagectomy Esophageal carcinoma Chemotherapy Adjuvant Female Surgery Esophagogastric Junction Neoplasm Recurrence Local business |
| Zdroj: | International Journal of Surgery. 12:1025-1030 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2014.08.400 |
| Popis: | Introduction : The standard treatment concept in patients with locally advanced adenocarcinoma of the esophagogastric junction is neoadjuvant chemotherapy, followed by tumor resection in curative intent. Response evaluation of neoadjuvant chemotherapy using histopathological tumor regression grade (TRG) has been shown to be a prognostic factor in patients with esophageal cancer. Methods : We assessed the impact of the various methods of response control and their value in correlation to established prognostic factors in a cohort of patients with adenocarcinoma at the gastroesophageal junction treated by neoadjuvant chemotherapy. Results : After neoadjuvant chemotherapy, in 56 consecutive patients with locally advanced (T2/3/4 and/or N0/N1) esophageal adenocarcinoma an oncologic tumor resection for curative intent was performed. Median follow-up was 44 months. Histopathological tumor stages were stage 0 in 10.7%, stage I in 17.9%, stage II in 21.4%, stage III in 41.1% and stage IV 8.9%. The 3-year overall survival (OS) rate was 30.3%. In univariate analysis, ypN-status, histopathological tumor stage and tumor regression grade correlated significantly with overall survival ( p = 0.022, p = 0.001, p = 0.035 respectively). Clinical response evaluation could not predict response and overall survival ( p = 0.556, p = 0.254 respectively). Conclusion : After preoperative chemotherapy, outcomes of esophageal carcinoma are best predicted utilizing pathological tumor stage and histologic tumor regression. Clinical response assessments were not useful for guidance of treatment. |
| Databáze: | OpenAIRE |
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