The prognostic significance of the positive circumferential resection margin in pathologic T3 squamous cell carcinoma of the esophagus with or without neoadjuvant chemotherapy

Surgery ◽  
2016 ◽  
Vol 159 (2) ◽  
pp. 441-450 ◽  
Author(s):  
Naoya Okada ◽  
Satoshi Fujii ◽  
Takeo Fujita ◽  
Jun Kanamori ◽  
Takashi Kojima ◽  
...  
2019 ◽  
Vol 27 (7) ◽  
pp. 713-721 ◽  
Author(s):  
Ryuta Nakao ◽  
Eiichi Konishi ◽  
Hitoshi Fujiwara ◽  
Eigo Otsuji ◽  
Isao Yokota ◽  
...  

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.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 20004-20004
Author(s):  
K. Shinjo ◽  
Y. Kajiyama ◽  
Y. T. Ishii ◽  
I. Nagaoka ◽  
M. Tsurumaru

20004 Background: The clinical significance of disseminated cancer cells in bone marrow has not been elucidated in esophageal cancer. The aim of this study was to evaluate the relation between quantity of disseminated cancer cells in bone marrow and clinical characteristics, including prognostic significance, in patients with squamous cell carcinoma of the esophagus using real time reverse transcriptase polymerase chain reaction (RT-PCR) for CEA (carcinoembryonic antigens) mRNA. Methods: Bone marrow samples were obtained from the 4th or 5th right rib on thoracotomy from consecutive 65 operative patients with esophageal squamous cell cancer, who received esophagectomy with lymph node dissection. After total RNA extraction, they were investigated by quantitative real time RT-PCR for CEA. We also performed qualitative analyses to confirm the results at least twice. We adopted quantitative results when qualitative analyses showed positive. Results: In bone marrow CEA mRNA was detected in 14 out of the 65 patients (21.5%). There were no significant differences in clinicopathological findings between positive and negative group for bone marrow CEA. However, after a short median follow-up of 12 months (3–19 months), 6 of 14 (42.9%) patients with positive CEA group had been dead compared to 4 out of 51 (7.8%) patients with negative CEA group. The survival time of both group showed a significant difference (p=0.0282). However, there was no relationship between the amount of cancer cells in bone marrow and patients’ survival. Conclusions: Disseminated cancer cells in bone marrow using quantitative RT-PCR for CEA mRNA may be a significant predictor for highly malignant squamous cell carcinoma of the esophagus. No significant financial relationships to disclose.


1995 ◽  
Vol 222 (2) ◽  
pp. 193-202 ◽  
Author(s):  
Shinichi Tsutsui ◽  
Hiroyuki Kuwano ◽  
Masayuki Watanabe ◽  
Masayuki Kitamura ◽  
Keizo Sugimachi

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