Complete Metabolic Response Is Not Uniformly Predictive of Complete Pathologic Response After Induction Therapy for Esophageal Cancer

2013 ◽  
Vol 96 (5) ◽  
pp. 1820-1825 ◽  
Author(s):  
Brendon M. Stiles ◽  
Gregory Salzler ◽  
Anna Jorgensen ◽  
Abu Nasar ◽  
Subroto Paul ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Induction Therapy ◽  
Metabolic Response ◽  
Pathologic Response ◽  
Complete Pathologic Response ◽  
Complete Metabolic Response

855 OPTIMIZATION OF SURGICAL DELAY AFTER INDUCTION CHEMORADIATION FOR ESOPHAGEAL CANCER: 10 YEARS RETROSPECTIVE MULTI-CENTER STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Alexis Legault-Dupuis ◽  
Philippe Bouchard ◽  
Frederic Nicodème ◽  
Jean-Pierre Gagne ◽  
Serge Simard ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Disease Free Survival ◽  
Pathologic Response ◽  
Complete Pathologic Response ◽  
Free Survival ◽  
Surgical Delay ◽  
Multi Center Study ◽  
Disease Free ◽  
Center Study

Abstract   The treatment of esophageal cancer is in constant evolution. Most of the esophageal cancer receive induction chemoradiation therapy. Surgical delay has been studied but the optimal timing has not been clarified. Through the years, surgical delay has been modified by surgeons in our institutions, going from an average of 6 weeks delay to an average of 10 weeks delay. It is time to ask if this change has a real positive impact on our patient. Methods In this retrospective multi-center study, we combined data from two center in Quebec city that performs oncologic esophagectomy. The surgical delay went from 6 to 10 weeks around 2014. All surgeons changed their practice at that moment. We retrospectively analysed 5 years before and after the change of practice and created two cohorts of patients. Our primary outcome compared complete pathologic response rate. Our secondary outcomes were surgical complications, anastomotic leak, disease free survival and overall survival. Results Thirty-eight patients had surgery under 8 weeks (mean: 6 weeks) after their induction chemoradiation compared to 64 patients that had surgery after 8 weeks (mean: 10 weeks). There was no statistical significant difference between groups for the complete pathologic response (32% vs 25%, p = 0,16). Important complications were similar, with a rate of 24% vs 28% (p = 0,69). Anastomotic leaks were less frequent in the less than 8 weeks group, but no statistical significance was obtained (13% vs 27%, p = 0,14).No difference in the disease-free survival rate and overall survival rate was noted (DFS 40% vs 55% (p = 0,32), OS 38% vs 38% (p = 0,29)). Conclusion The treatment of esophageal cancer is in constant evolution, induction therapy and surgical technics involve over time. Surgical delay has no impact on complete pathologic response, complication and overall survival. There is no advantage to wait longer before surgery.

Neoadjuvant chemotherapy versus chemoradiation prior to esophagectomy: Impact on rate of complete pathologic response and survival in esophageal cancer patients.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 4054-4054
Author(s):  
Albert C. Lockhart ◽  
Pamela Parker Samson ◽  
Cliff Grant Robinson ◽  
Jeffrey D. Bradley ◽  
Varun Puri ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Pathologic Response ◽  
Complete Pathologic Response

Patterns and predictors of locoregional recurrence following neoadjuvant chemoradiation for esophageal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 173-173
Author(s):  
Aaron Udell Blackham ◽  
Will Jin ◽  
Khaldoun Almhanna ◽  
Jacques-Pierre Fontaine ◽  
Sarah E. Hoffe ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymphovascular Invasion ◽  
Lymph Node Ratio ◽  
Distant Recurrence ◽  
Neoadjuvant Chemoradiation ◽  
Pathologic Response ◽  
Complete Pathologic Response ◽  
Predicting Factors ◽  
Node Ratio

173 Background: Despite neoadjuvant chemoradiation (nCRT) followed by esophagectomy for locally advanced esophageal cancer, locoregional recurrences (LRR) are common. Specific risk factors for LRR have yet to be identified. Methods: Patients with esophageal cancer who were treated with nCRT and esophagectomy were identified from a single institution, prospectively maintained database(1996-2013). Timing and locations of recurrences were described and predicting factors of LRR were analyzed. Results: Out of 456 patients treated with nCRT for esophageal cancer, 167 patients developed known recurrence. Locoregional and distant recurrences were observed in 69(15.1%) and 140(30.9%) patients, respectively. Median recurrence-free survival was 38.5 months with a median follow-up of 30.4 months. Sixty-eight patients(40.7%) developed recurrence at multiple sites. The median time to recurrence was 13.5 months and survival following recurrence was only 8.0 months in the 27 patients(16.2%) with solitary LRR. Overall survival in patients with solitary LLR was 23.6 months, compared to 20.8 months in all patients who developed distant recurrence. Univariate analysis identified lymph node ratio > 0.5(OR 2.42, p = 0.030), non-complete pathologic response(OR 1.90, p = 0.022), positive margins(OR 3.58, p = 0.028) and lymphovascular invasion(OR 2.82, p = 0.001) as significant predicting factors for LRR. While perineural invasion(p = 0.055), nodal stage(0.053) and use of adjuvant therapy(p = 0.060) approached significance, other factors such as tumor stage, type of surgery (Ivor-Lewis vs transhiatal), radiation dose and use of IMRT were not significant predictors of LRR. Only lymphovascular invasion was an independent predictor of LRR. Conclusions: Prognosis following LRR in patients with esophageal cancer treated with nCRT is poor but is better than in patients who develop distant recurrence. High lymph node ratio, positive margin status, non-complete pathologic response and the presence of lymphovascular invasion are predictive of LRR following nCRT for esophageal cancer.

scholarly journals Complete Pathologic Response After Neoadjuvant Chemoradiotherapy for Esophageal Cancer Is Associated With Enhanced Survival

2009 ◽  
Vol 87 (2) ◽  
pp. 392-399 ◽  
Author(s):  
James M. Donahue ◽  
Francis C. Nichols ◽  
Zhuo Li ◽  
David A. Schomas ◽  
Mark S. Allen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathologic Response ◽  
Complete Pathologic Response

scholarly journals Neoadjuvant Chemotherapy versus Chemoradiation Prior to Esophagectomy: Impact on Rate of Complete Pathologic Response and Survival in Esophageal Cancer Patients

2016 ◽  
Vol 11 (12) ◽  
pp. 2227-2237 ◽  
Author(s):  
Pamela Samson ◽  
Clifford Robinson ◽  
Jeffrey Bradley ◽  
A. Craig Lockhart ◽  
Varun Puri ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Pathologic Response ◽  
Complete Pathologic Response

scholarly journals Complete pathologic response is independent of the timing of esophagectomy following neoadjuvant chemoradiation for esophageal cancer

2018 ◽  
Vol 9 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Smit Singla ◽  
Emmanuel Gabriel ◽  
Raed Alnaji ◽  
William Du ◽  
Kristopher Attwood ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemoradiation ◽  
Pathologic Response ◽  
Complete Pathologic Response
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