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Gastric Cancer
Erschienen in: Gastric Cancer 3/2014

01.07.2014 | Original Article

Interim endoscopy results during neoadjuvant therapy for gastric cancer correlate with histopathological response and prognosis

verfasst von: Ulrike Heger, Franz Bader, Florian Lordick, Maria Burian, Rupert Langer, Martin Dobritz, Susanne Blank, Thomas Bruckner, Karen Becker, Ken Herrmann, Jörg-Rüdiger Siewert, Katja Ott

Erschienen in: Gastric Cancer | Ausgabe 3/2014

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Abstract

Background

Neoadjuvant chemotherapy for locally advanced gastric cancer leads to major histopathological response in less than 30 % of patients. Data on interim endoscopic response assessment do not exist. This exploratory prospective study evaluates early endoscopy after 50 % of the chemotherapy as predictor for later response and prognosis.

Methods

Forty-seven consecutive patients were included (45 resected; 33 R0 resections). All patients received baseline endoscopy and CT scans, after 50 % of their chemotherapy (EGD-1, CT-1) and after completion of chemotherapy (EGD-2, CT-2). Interim endoscopic response (EGD-1) was assessed after having received 50 % (6 weeks) of the planned 12 weeks of neoadjuvant chemotherapy. Post-chemotherapy response was clinically assessed by a combination of CT scan (CT-2) and endoscopy (EGD-2). Histopathological response was determined by a standardized scoring system (Becker criteria). Endoscopic response was defined as a reduction of >75 % of the tumor mass.

Results

Twelve patients were responders at EGD-1 and 13 at EGD-2. Nine patients (19.1 %) were clinical responders and 7 patients (15.6 %) were histopathological responders after chemotherapy. Specificity, accuracy, and negative predictive value of the interim EGD-1 for subsequent histopathological response were 31/38 (82 %), 36/47 (76 %), and 31/33 (93 %); and for recurrence or death, 28/30 (93.3 %), 38/47 (80.9 %), and 28/35 (80.0 %). Response at EGD-1 was significantly associated with histopathological response (p = 0.010), survival (p < 0.001), and recurrence-free survival (p = 0.009).

Conclusions

Interim endoscopy after 6 weeks predicts response and prognosis. Therefore, tailoring treatment according to interim endoscopic assessment could be feasible, but the findings of this study should be validated in a larger patient cohort.
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Metadaten
Titel
Interim endoscopy results during neoadjuvant therapy for gastric cancer correlate with histopathological response and prognosis
verfasst von
Ulrike Heger
Franz Bader
Florian Lordick
Maria Burian
Rupert Langer
Martin Dobritz
Susanne Blank
Thomas Bruckner
Karen Becker
Ken Herrmann
Jörg-Rüdiger Siewert
Katja Ott
Publikationsdatum
01.07.2014
Verlag
Springer Japan
Erschienen in
Gastric Cancer / Ausgabe 3/2014
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-013-0296-0

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