Prognostic significance of tumor regression grade for patients with esophageal squamous cell carcinoma after neoadjuvant chemotherapy followed by surgery

2016 ◽  
Vol 113 (4) ◽  
pp. 390-396 ◽  
Author(s):  
Ken Hatogai ◽  
Satoshi Fujii ◽  
Takashi Kojima ◽  
Hiroyuki Daiko ◽  
Tomohiro Kadota ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tumor Regression ◽  
Prognostic Significance ◽  
Tumor Regression Grade ◽  
Regression Grade

A preoperative nomogram for tumor regression grade following induction chemotherapy for esophageal squamous cell carcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15525-e15525
Author(s):  
Xiaozheng Kang ◽  
Liang Dai ◽  
Wanpu Yan ◽  
Yongbo Yang ◽  
Haitao Zhou ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Continuous Distribution ◽  
Tumor Regression Grade ◽  
Regression Grade

e15525 Background: To (1) evaluate the continuous distribution of tumor regression grade (TRG) in resection specimens after induction chemotherapy for locally advanced esophageal squamous cell carcinoma (ESCC), (2) determine the effects of TRG on survival after esophagectomy, and (3) identify preoperative predictors of TRG. Methods: From June 2001 to October 2012, 212 patients underwent induction chemotherapy followed by esophagectomy for locally advanced ESCC. TRG, assessed as the percentage of residual primary ESCC cells in resection specimens, was classified histologically by pathologists. Random Forest technology was used for data analysis. A nomogram was developed allowing prediction of TRG through use of preoperative clinical factors for patients with clinically locally advanced ESCC who are candidates for treatment with a radical esophagectomy. Results: Twenty-four specimens (11%) had no residual primary cancer (ypT0), 39 (18%) had 1% to 10% residual cancer, 48 (23%) had 11% to 50%, 101 (48%) had more than 50%. Survival was worse with increasing residual primary ESCC, plateauing at 50%. Poorer TRG was associated with worse 3-year overall survival. Better pathologic grade (G), larger number of pack year smoking, fewer cycles of induction chemotherapy, lower level of creatinine, younger age, greater tumor length and clinical T stage were associated with poorer TRG. Conclusions: Better TRG in response to preoperative chemotherapy is associated with a linear increase in survival after esophagectomy for locally advanced ESCC. A nomogram has been developed that can be used to predict TRG. Therefore, for patients with poorer TRG, the role of adjuvant therapy needs to be further assessed in an attempt to improve survival.

scholarly journals Significance of chemotherapy-free interval and tumor regression grade in patients with recurrent esophageal squamous cell carcinoma receiving chemotherapy with fluorouracil and platinum after esophagectomy following preoperative chemotherapy

Esophagus ◽  
2021 ◽  
Author(s):  
Mashiro Okunaka ◽  
Daisuke Kotani ◽  
Ken Demachi ◽  
Hisashi Fujiwara ◽  
Shingo Sakashita ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Preoperative Chemotherapy ◽  
Squamous Cell ◽  
Recurrent Disease ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Free Interval ◽  
Regression Grade

Abstract Background In Japan, standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC) includes preoperative chemotherapy with fluorouracil plus cisplatin followed by esophagectomy. However, its efficacy is unclear in patients with recurrent disease with < 6 months of chemotherapy-free interval (CFI) after preoperative chemotherapy followed by esophagectomy and in those with ≥ 6 months of CFI and poor pathological response to prior preoperative chemotherapy. Method We retrospectively evaluated the efficacy of fluorouracil plus platinum in patients with recurrent ESCC who received preoperative chemotherapy followed by curative esophagectomy. Results Among 105 patients with recurrent ESCC after preoperative chemotherapy followed by esophagectomy, a total of 55 patients received fluorouracil plus platinum for recurrent disease. Patients with a CFI < 6 months (n = 20) had significantly shorter overall survival (OS) (median, 7.1 vs 14.5 months, P = 0.008) compared with those with a CFI ≥ 6 months (n = 35). Multivariate analysis showed that OS was worse in patients with a CFI < 6 months or a tumor regression grade (TRG) ≤ 1a. Furthermore, in patients with a CFI ≥ 6 months, TRG ≤ 1a was associated with significantly shorter OS (11.1 months vs. not reached, P = 0.001). Conclusion Fluorouracil plus platinum was ineffective for recurrent ESCC in patients with a CFI < 6 months and in those with a CFI ≥ 6 months and a TRG ≤ 1a. Alternate regimens including nivolumab or pembrolizumab might be considered for the treatment for recurrence in these patients.

scholarly journals GASC1-Adapted Neoadjuvant Chemotherapy for Resectable Esophageal Squamous Cell Carcinoma: A Prospective Clinical Biomarker Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ruinuo Jia ◽  
Youjia Mi ◽  
Xiang Yuan ◽  
Dejiu Kong ◽  
Wanying Li ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tumor Regression ◽  
Objective Response ◽  
Tumor Regression Grade ◽  
Potential Biomarker ◽  
Significant Difference

Neoadjuvant chemotherapy (NCT) is a standard care for esophageal squamous cell carcinoma (ESCC), but the efficacy is unsatisfactory. Cancer stem cells (CSCs) play key roles in chemotherapy resistance. Gene amplified in squamous cell carcinoma 1 (GASC1) is a neoteric gene in stemness maintaining of ESCC. We aimed to reveal whether GASC1 could be a predictive biomarker for NCT in ESCC. ESCC patients (T2-4N0-2M0) were evaluated for GASC1 expression using immunohistochemical staining and classified as GASC1-low group (GLG) and GASC1-high group (GHG). NCT was delivered in two cycles and then the surgery was completed. Primary endpoints were tumor regression grade (TRG) and objective response rate (ORR); secondary endpoints were radical surgical resection (R0) rate and three-year overall survival (OS). 60 patients were eligible with evaluable outcomes: 24 in GHG and 36 in GLG. Between GHG and GLG, TRG1, TRG2, TRG3, and TRG4 were 0 : 16.7%, 20.8% : 41.7%, 58.3% : 36.1%, and 20.8% : 5.6%, respectively (P=0.006); ORR and R0 rate were 33.3% : 69.4% (P=0.006) and 75% : 94.4% (P=0.046), respectively; the median OS was 20 : 32 (months) (P=0.0356). No significant difference in the three-year OS was observed between GHG and GLG: 29.2% : 41.7% (P=0.24). Furthermore, the GASC1 expression level was associated with poor OS independent of other factors by univariate and multivariate analyses. Therefore, GASC1 might be a potential biomarker to predict NCT efficacy for ESCC.

FA06.01: CLINICAL EFFECT OF NEOADJUVANT CHEMOTHERAPY OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA FOR SUPERFICIAL PHARYNGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 11-11
Author(s):  
Hiroki Ishida ◽  
Hirofumi Kawakubo ◽  
Shuhei Mayanagi ◽  
Kazumasa Fukuda ◽  
Rieko Nakamura ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Median Duration ◽  
Systemic Chemotherapy ◽  
Tumor Regression ◽  
Flat Type ◽  
Pharyngeal Squamous Cell Carcinoma

Abstract Background Esophageal squamous cell carcinoma (ESCC) is often synchronously accompanied by pharyngeal squamous cell carcinoma (PSCC). However, the treatment strategies for these cancers have not been established. Neoadjuvant chemotherapy is the standard treatment for advanced ESCC and is also effective for PSCC patients. However, few studies have focused on the efficacy of systemic chemotherapy for patients with superficial PSCC. Methods We retrospectively examined 22 cases of superficial PSCC that occurred in 14 patients with ESCC who received neoadjuvant therapy between January 2011 and June 2017. Results Of the 14 patients, 13 (93%) were male, and the median age was 63.5 years (range: 35–74 years). The clinical stage of ESCC was II for 7, III for 5, and IVB for 2 (AJCC 8th staging system). The PSCC origin included the oropharynx in 9 lesions (40.9%) and the hypopharynx in 13 lesions (59.1%). Macroscopic type was classified as protruding (type1 or 0-I) for 2, superficial elevated (0-IIa) for 5, superficial flat (0-IIb) for 13, and superficial depressed (0-IIc) for 2. The estimated depth of invasion was EP in 12 lesions, SEP in 8 lesions, and MP in 2 lesions. FP regimen was administered to 11 patients in 15 lesions and DCF to 3 patients in 7 lesions. One patient had concurrent chemoradiotherapy. Chemotherapy for PSCC resulted in CR in 10 lesions (45.4%). In CR, 9 of 10 lesions were of superficial flat type. All non-CR lesions also had tumor regression. In the CR patients, 5 lesions(50%) had local recurrence, and the median duration until recurrence was 4 months (range: 4 to 17 months). Endoscopic resection(ER) for PSCC was performed in the 13 lesions after esophagectomy. The median duration after diagnosis was 7 months (range: 3 to 20 months). Conclusion Systemic chemotherapy of ESCC has tumor regression potential for superficial flat-type PSCC with clinical tumor invasion in EP or SEP. Although chemotherapy for PSCC results in non-CR, additional ER is quite effective. Because half of the CR lesions had recurrence, strict follow-up and observation of the pharynx are reasonable options for patients with ESCC. Disclosure All authors have declared no conflicts of interest.

Residual Cancer Volume Predicts Clinical Outcome in Patients With Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemotherapy

2019 ◽  
Vol 27 (7) ◽  
pp. 713-721 ◽  
Author(s):  
Ryuta Nakao ◽  
Eiichi Konishi ◽  
Hitoshi Fujiwara ◽  
Eigo Otsuji ◽  
Isao Yokota ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Multivariate Analyses ◽  
Prognostic Significance ◽  
Curve Analysis ◽  
Residual Cancer ◽  
Cutoff Value

Background. The aim of this study was to assess the prognostic significance of residual cancer volume (RCV) in patients with esophageal squamous cell carcinoma (ESCC) who received esophagectomy after neoadjuvant chemotherapy. Methods. We measured RCV by using complete stepwise sections at 6- to 8-mm intervals obtained from 81 ESCC patients with clinical stages IB to III. RCV was defined as the summation of all products of residual cancer area and thickness, and its cutoff value was set by receiver operator characteristic curve analysis on 3-year disease-specific survival (DSS). The multivariate analyses were performed in comparison with histopathological factors including tumor regression grades according to the Japanese Classification of Esophageal Cancer (TRG-JPN) or reported by Becker et al (TRG-Becker). Results. The range of RCV was 0 to 49.3 cm3 (median = 1.4 cm3), and the cutoff value was set at 1.0 cm3 (sensitivity = 78%; specificity = 68%). In the Kaplan-Meier curve analysis with the log-rank test, RCV > 1.0 cm3 predicted poorer prognosis for relapse-free survival (RFS; 5-year RFS rate, 12% vs 47%; P < .001) and DSS (5-year DSS rate, 27% vs 61%; P < .001). The multivariate analyses by the Cox hazards model revealed that RCV > 1.0 cm3 was a factor predicting poor prognosis for RFS ( P = .013; hazard ratios [HR] = 2.62) and DSS ( P = .028; HR = 2.56) compared with histopathological factors including TRG-JPN; RFS ( P = .014; HR = 3.03) and DSS ( P = .045; HR = 2.71) compared with histopathological factors including TRG-Becker. Conclusions. The study suggested that determining RCV is a new method of predicting prognosis in ESCC patients after neoadjuvant chemotherapy.

Prognostic Value of Tumor Regression Grade Based on Ryan Score in Squamous Cell Carcinoma and Adenocarcinoma of Esophagus

2019 ◽  
Vol 27 (4) ◽  
pp. 1241-1247 ◽  
Author(s):  
Flávio Roberto Takeda ◽  
Francisco Tustumi ◽  
Carlos de Almeida Obregon ◽  
Gustavo Gonçalves Yogolare ◽  
Yasmin Peres Navarro ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Value ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Adenocarcinoma Of Esophagus ◽  
Regression Grade
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