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24.03.2023 | Original Article

Prognostic impact of endoscopic response evaluation after neoadjuvant chemotherapy for esophageal squamous cell carcinoma: a nationwide validation study

verfasst von: Satoru Matsuda, Yuko Kitagawa, Jun Okui, Akihiko Okamura, Hirofumi Kawakubo, Ryo Takemura, Koji Kono, Manabu Muto, Yoshihiro Kakeji, Hiroya Takeuchi, Masayuki Watanabe, Yuichiro Doki

Erschienen in: Esophagus | Ausgabe 3/2023

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Abstract

Background

Our previous study reported the prognostic significance of endoscopic response (ER) evaluation, defined ER, and revealed ER as an independent prognostic factor of overall survival (OS) and recurrence-free survival (RFS) for esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemotherapy (NAC) and surgery. The present study aimed to validate the prognostic impact of ER using a nationwide database from the authorized institute for board-certified esophageal surgeons by the Japan Esophageal Society.

Methods

This study retrospectively reviewed patients with ESCC who underwent subtotal esophagectomy at 85 authorized institutes for esophageal cancer from 2010 to 2015. Patients were classified as ER when the tumor size was markedly reduced post-NAC compared to pre-NAC. The correlation between OS and RFS was investigated.

Results

Of 4781 patients initially enrolled, 3636 were selected for subsequent analysis. Of them, 642 (17.7%) patients were classified as the ER group. Patients with ER showed significantly better OS and RFS. Subgroup analysis revealed the statistical difference in OS and RFS in cStage II and III, while the magnitude of survival difference between ER and non-ER was not evident in cStage I and IV. The percentage of ER varied from 46 to 87% among groups when institutions were classified into 3 subgroups based on the hospital volume, which would indicate the interinstitutional inconsistency.

Conclusions

The prognostic impact of ER was validated using a nationwide database. Standardization of ER evaluation is required to improve the interinstitutional consistency and clinical validity of the ER evaluation.

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Titel: Prognostic impact of endoscopic response evaluation after neoadjuvant chemotherapy for esophageal squamous cell carcinoma: a nationwide validation study
verfasst von: Satoru Matsuda
Yuko Kitagawa
Jun Okui
Akihiko Okamura
Hirofumi Kawakubo
Ryo Takemura
Koji Kono
Manabu Muto
Yoshihiro Kakeji
Hiroya Takeuchi
Masayuki Watanabe
Yuichiro Doki
Publikationsdatum: 24.03.2023
Verlag: Springer Nature Singapore
Erschienen in: Esophagus / Ausgabe 3/2023
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI: https://doi.org/10.1007/s10388-023-00998-x

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Prognostic impact of endoscopic response evaluation after neoadjuvant chemotherapy for esophageal squamous cell carcinoma: a nationwide validation study