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01.12.2014 | Research | Ausgabe 1/2014 Open Access

World Journal of Surgical Oncology 1/2014

Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2014
Autoren:
Ren-Wen Huang, Yin-Kai Chao, Yu-Wen Wen, Hsien-Kun Chang, Chen-Kan Tseng, Sheng-Chieh Chan, Yun-Hen Liu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-12-170) contains supplementary material, which is available to authorized users.

Competing interests

All authors declare no conflicts of interest.

Authors' contributions

YKC had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. RWH and YKC contributed to the conception and design of the study, data acquisition, analysis and interpretation of the data, and the writing and revision of the manuscript. YWW contributed to the data analysis and statistical analysis. HKC, CKT, SCC and YHL contributed to quality control of the data and the manuscript review. All authors read and approved the final manuscript.

Abstract

Backgrounds

In this study, we evaluated the factors associated with a pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for esophageal squamous cell carcinoma (ESCC).

Methods

Pre-nCRT parameters in ESCC patients treated between 1999 and 2006 were analyzed to identify predictors of pCR. All patients received 5-fluorouracil/cisplatin-based chemotherapy and external beam radiation followed by scheduled esophagectomy. Variables were analyzed using univariate and multivariate analyses with pCR as the dependent variable. Estimated pCR rate was calculated with a regression model.

Results

Fifty-nine (20.9%) of 282 patients achieved pCR. Univariate analysis identified four patient factors (age, smoking status, drinking history and hypertension), one pre-nCRT parameter (tumor length) as significant predictors of pCR (all P <0.05). On multivariate analysis, tumor length ≤3 cm (favorable, odds ratio (OR): 4.85, P = 0.001), patient age >55 years (favorable, OR: 1.95, P = 0.035), and being a non-smoker (favorable, OR: 3.6, P = 0.003) were independent predictors of pCR. The estimated pCR rates based on a logistic regression including those three predictors were 71%, 35 to approximately 58%, 19 to approximately 38%, and 12% for patients with 3, 2, 1 and 0 predictors, respectively.

Conclusion

Age, smoking habit and tumor length were important pCR predictors. These factors may be used to predict outcomes for ESCC patients receiving nCRT, to develop risk-adapted treatment strategies, and to select patients who could participate in trials on new therapies.
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