The Impact of Tumor Regression on Prognosis After Neoadjuvant Chemoradiotherapy in Surgically Treated Esophageal Adenocarcinoma
- 29.01.2022
- Thoracic Oncology
Erschienen in:
- Verfasst von
- D. J. Crull, MD
- M. C. H. Hogenes, MD, PhD
- R. Hoekstra, MD, PhD
- E. M. Hendriksen, MD
- M. J. van Det, MD, PhD
- E. A. Kouwenhoven, MD, PhD
- Erschienen in
- Annals of Surgical Oncology | Ausgabe 6/2022
Abstract
Background
The 5-year survival for patients with esophageal carcinoma remains poor despite neoadjuvant therapy and surgery. The eighth American Joint Committee on Cancer (AJCC) staging, based on the neoadjuvant treated TNM (ypTNM) stage of the resection specimen, is used for prognosis. Tumor characteristics such as tumor grade, subtype of adenocarcinoma, and tumor regression scores are not included in this classification. This study aimed to determine the impact of these tumor characteristics on overall survival (OS) and disease-free survival (DFS).
Methods
This retrospective cohort study included 228 patients with esophageal adenocarcinoma. Tumor regression was determined by the Mandard tumor regression (MTR) score. Subtype and grade of adenocarcinoma were confirmed using either the preoperative biopsy or residual tumor tissue after surgery. The MTR was modified to a three-tier classification. The study classified MTR 1 and 2 in one group as a “major response,” with MTR 4 and 5 classified in one group as a “minimal response.”
Results
The median follow-up period was 2.1 years. Combining MTR with AJCC staging did not improve the prognostic value for the prediction of OS. However, the multivariate analysis showed that the prognostic value of AJCC staging for DFS was improved by adding the three-tiered MTR (odds ratio for MTR4+5: 2.46; 95 % confidence interval, 1.07–5.67). Grade or subtype correlated with neither OS nor DFS in the univariate analyses and did not improve the prognostic value of the AJCC staging.
Conclusion
Neither adenocarcinoma subtype nor grade influenced OS or DFS. However, the eighth AJCC staging combined with a three-tier MTR provided a better prognostic tool for DFS in esophageal adenocarcinoma treated with esophagectomy after neoadjuvant chemoradiotherapy.
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- Titel
- The Impact of Tumor Regression on Prognosis After Neoadjuvant Chemoradiotherapy in Surgically Treated Esophageal Adenocarcinoma
- Verfasst von
-
D. J. Crull, MD
M. C. H. Hogenes, MD, PhD
R. Hoekstra, MD, PhD
E. M. Hendriksen, MD
M. J. van Det, MD, PhD
E. A. Kouwenhoven, MD, PhD
- Publikationsdatum
- 29.01.2022
- Verlag
- Springer International Publishing
- Erschienen in
-
Annals of Surgical Oncology / Ausgabe 6/2022
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681 - DOI
- https://doi.org/10.1245/s10434-022-11336-3
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