Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: A retrospective cohort study

Rizvi, Farrukh Hassan; Syed, Aamir Ali; Khattak, Shahid; Rizvi, Syed Shahrukh Hassan; Kazmi, Sakina; Khan, Muhammad Qayum

doi:10.1016/j.ijsu.2014.04.014

Cited by 30 publications

(24 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Undoubtedly, an accurate determination of TRG requires a meticulous search of residual viable tumor cells, especially in cases who achieve pCR. Although many studies have investigated the achievement of pCR in patients treated with nCRT, the question as to whether the thoroughness of the pathologic examination can be related to survival has not been previously addressed …”

Section: Discussionmentioning

confidence: 99%

“…The achievement of a pathological complete response (pCR) − defined as the absence of residual cancer in the resected specimens − is commonly considered as the hallmark of an effective nCRT. In this regard, patients who achieve pCR following nCRT are the subgroup who may experience the highest benefits from such a strategy . Nonetheless, the inability to identify residual tumor cells in surgical specimens should by no means be considered as a synonymous of cure because up to one third of such patients will ultimately develop disease recurrences .…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, patients who achieve pCR following nCRT are the subgroup who may experience the highest benefits from such a strategy. 3,4 Nonetheless, the inability to identify residual tumor cells in surgical specimens should by no means be considered as a synonymous of cure because up to one third of such patients will ultimately develop disease recurrences. [4][5][6][7][8] To date, there have been only a few studies that have attempted to identify the main risk factors for disease recurrence.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between the thoroughness of the histopathological examination and survival in patients with esophageal squamous cell carcinoma who achieve pathological complete response after chemoradiotherapy

Chen

Wen

et al. 2015

Dis Esophagus

View full text Add to dashboard Cite

The College of American Pathologists guidelines recommend examining at least four representative tumor blocks for determining pathological T stage in patients with primarily resected esophageal cancer. Whether the same pathological requirements are adequate in patients undergoing esophagectomy following neoadjuvant chemoradiotherapy (nCRT) remains unclear. We hypothesized that current examination protocols may underestimate the presence of microscopical residual disease after nCRT, potentially leading to under-staging. We retrospectively reviewed the records of patients with esophageal squamous cancer (ESCC) who were diagnosed as having pathological complete response (pCR) following nCRT. The thoroughness of the pathological examination in pCR patients was examined using (i) the number of blocks examined in suspicious tumor area (≤4 vs. >4), and (ii) the block quotient (calculated as the pretreatment tumor length divided by the number of blocks examined in suspicious tumor area). A total of 91 patients were enrolled. The mean number of blocks used to confirm pCR was 4.8 (range: 2-14). The 5-year overall survival (OS) and disease-free survival (DFS) in the entire cohort were 55% and 65%, respectively. Multivariate analyses identified the block quotient as the only independent predictor of OS and DFS. Receiver operating characteristic curve analysis indicated an optimal cutoff value of 1.4 for the block quotient. Among the patients who achieved pCR, the 5-year DFS differed significantly between subjects with a low (≤1.4) or high (>1.4) block quotient (76% vs. 47%, respectively, P = 0.03). The block quotient (calculated by the pretreatment tumor length divided by the number of blocks) - which reflects the meticulousness of the histopathological examination for confirming pCR - is associated with survival in ESCC patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between the thoroughness of the histopathological examination and survival in patients with esophageal squamous cell carcinoma who achieve pathological complete response after chemoradiotherapy

Chen

Wen

et al. 2015

Dis Esophagus

View full text Add to dashboard Cite

show abstract

“…[2,3] Notably, patients who successfully respond to nCRT are those who benefit most from such strategy. [4][5][6] Major histopathological response (MaHR) -defined as absent or <10% vital residual tumor cells (VRTC) in the resected esophagus without nodal involvement -is a commonly used criterion for defining a favorable response to nCRT. [7][8][9][10] However, the question as to whether the presence of small residual tumors (1-10% VRTC) should be considered as MaHR remains open.…”

Section: Introductionmentioning

confidence: 99%

Prognosis of patients with esophageal squamous cell carcinoma who achieve major histopathological response after neoadjuvant chemoradiotherapy

Chao

Chuang

Chang

et al. 2017

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

“…Neoadjuvant treatment for locally advanced esophageal cancer is the standard of care [1, 2]. Esophagectomy has historically remained a very morbid procedure [3].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Esophagectomy for Esophageal Cancer: The First Experience from Pakistan

Rizvi

Syed

et al. 2014

International Journal of Surgical Oncology

Self Cite

View full text Add to dashboard Cite

Background. Two common procedures for esophageal resection are Ivor Lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20–46%. Minimally invasive esophagectomy has been introduced to decrease morbidity. We report initial experience of MIE to determine the morbidity and mortality associated with this procedure during learning phase. Material and Methods. Patients undergoing MIE at our institute from January 2011 to May 2013 were reviewed. Record was kept for any morbidity and mortality. Descriptive statistics were presented as frequencies and continuous variables were presented as median. Survival analysis was performed using Kaplan Meier curves. Results. We performed 51 minimally invasive esophagectomies. Perioperative morbidity was in 16 (31.37%) patients. There were 3 (5.88%) anastomotic leaks. We encountered 1 respiratory complication. Reexploration was required in 3 (5.88%) patients. Median operative time was 375 minutes. Median hospital stay was 10 days. The most frequent long-term morbidity was anastomotic narrowing observed in 5 (9.88%) patients. There were no perioperative mortalities. Our mean overall survival was 37.66 months (95% confidence interval 33.75 to 41.56 months). Mean disease-free survival was 24.43 months (95% CI 21.26 to 27.60 months). Conclusion. Minimally invasive esophagectomy, when performed in the learning phase, has acceptable morbidity and mortality.

show abstract

Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: A retrospective cohort study

Abstract: Complete Pathological response significantly improves overall and disease free survival. It is also the predictor of long term survival.

Cited by 30 publications

References 16 publications

Association between the thoroughness of the histopathological examination and survival in patients with esophageal squamous cell carcinoma who achieve pathological complete response after chemoradiotherapy

Association between the thoroughness of the histopathological examination and survival in patients with esophageal squamous cell carcinoma who achieve pathological complete response after chemoradiotherapy

Prognosis of patients with esophageal squamous cell carcinoma who achieve major histopathological response after neoadjuvant chemoradiotherapy

Minimally Invasive Esophagectomy for Esophageal Cancer: The First Experience from Pakistan

Contact Info

Product

Resources

About