Histologic subtypes as determinants of outcome in esophageal carcinoma patients with pathologic complete response after preoperative chemoradiotherapy
- 13 December 2005
- Vol. 106 (3), 552-558
- https://doi.org/10.1002/cncr.21601
Abstract
BACKGROUND The current study tested the hypothesis that the clinical outcome of patients with localized esophageal carcinoma after preoperative chemoradiotherapy (CTRT) depends on histology. METHODS The authors stratified patients by adenocarcinoma (ACA) or squamous cell carcinoma (SCC) and compared the overall survival (OS) and patterns of failure among patients achieving pathologic complete response (pathCR) and < pathCR after preoperative CTRT. A correlation between baseline clinical stage and posttherapy pathologic response was made for ACA and SCC. RESULTS Of the 235 patients who underwent preoperative CTRT, 42 (18%) had SCC and 193 (82%) had ACA. In the ACA group, 56 patients (29%) achieved a pathCR and in the SCC group 13 patients (31%) achieved a pathCR. In the ACA group, a larger proportion of pathCR patients (n = 44; 79%) than < pathCR patients (n = 82; 60%) were alive at the time of last follow‐up (P = 0.01) and pathCR patients had a longer OS than < pathCR patients (P = 0.0006). However, in the SCC group OS or proportion alive did not differ significantly between pathCR and < pathCR patients (P ≥ 0.05). In the ACA group, a greater portion of < pathCR patients (32%) than pathCR patients (16%) had distant metastases (P = 0.02) and the distant metastases‐free survival of pathCR patients was longer than that of < pathCR patients (P = 0.0012). In the SCC group, the proportion or time to distant‐metastases did not differ significantly. Pretreatment clinical stage did not correlate with pathologic response for either histology. CONCLUSIONS The results of the current study suggest that the clinical biology of SCC and ACA is different after CTRT. An investigation of molecular and patient genetics is needed to improve therapy. Cancer 2006. © 2005 American Cancer Society.Keywords
This publication has 18 references indexed in Scilit:
- Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete responseCancer, 2005
- Failure patterns correlate with the proportion of residual carcinoma after preoperative chemoradiotherapy for carcinoma of the esophagusCancer, 2005
- Posttherapy pathologic stage predicts survival in patients with esophageal carcinoma receiving preoperative chemoradiationCancer, 2005
- Annual report to the nation on the status of cancer, 1975-2001, with a special feature regarding survivalCancer, 2004
- Improved Prognosis of Resected Esophageal CancerWorld Journal of Surgery, 2004
- Esophageal CancerThe New England Journal of Medicine, 2003
- Three-Field Lymph Node Dissection for Squamous Cell and Adenocarcinoma of the EsophagusAnnals of Surgery, 2002
- Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trialThe Lancet, 2002
- Radical Lymph Node Dissection for Cancer of the Thoracic EsophagusAnnals of Surgery, 1994
- Surgical Strategies in Esophageal Carcinoma With Emphasis on Radical LymphadenectomyAnnals of Surgery, 1992