Prognostic impact of endoscopic response evaluation after neoadjuvant chemotherapy for esophageal squamous cell carcinoma: a nationwide validation study

Matsuda, Satoru; Kitagawa, Yuko; Okui, Jun; Okamura, Akihiko; Kawakubo, Hirofumi; Takemura, Ryo; Kono, Koji; Muto, Manabu; Kakeji, Yoshihiro; Takeuchi, Hiroya; Watanabe, Masayuki; Doki, Yuichiro

doi:10.1007/s10388-023-00998-x

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…We employed a stricter criterion to exclude any residual disease based on endoscopic findings, resulting in high specificity (0.88) and moderate sensitivity (0.67) in predicting MPR. Previous neoadjuvant chemotherapy studies have demonstrated a strong correlation between endoscopic response according to post-neoadjuvant macroscopic findings and pathologic response, with higher percentages of histological responders in endoscopic responders (45−58%) compared to endoscopic non-responders (7-16%) [46][47][48]. While the specificity and sensitivity of endoscopic evaluation slightly differ from our study due to different evaluation criteria, these Japanese studies support our findings.…”

Section: Discussionsupporting

confidence: 86%

Enhancing Prediction for Tumor Pathologic Response to Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Cancer by Dynamic Parameters from Clinical Assessments

Song,

Liu,

et al. 2023

Cancers

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To develop accurate and accessible prediction methods for assessing pathologic response following NICT prior to surgery, we conducted a retrospective study including 137 patients with esophageal squamous cell carcinoma (ESCC) who underwent surgery after two cycles of NICT between January 2019 and March 2022 at our center. We collected clinical parameters to evaluate the dynamic changes in the primary tumor. Univariate and multivariate analyses were performed to determine the correlations between these parameters and the pathologic response of the primary tumor. Subsequently, we constructed prediction models for pCR and MPR using multivariate logistic regression. The MPR prediction Model 2 was internally validated using bootstrapping and externally validated using an independent cohort from our center. The univariate logistic analysis revealed significant differences in clinical parameters reflecting tumor regression among patients with varying pathologic responses. The clinical models based on these assessments demonstrated excellent predictive performance, with the training cohort achieving a C-index of 0.879 for pCR and 0.912 for MPR, while the testing cohort also achieved a C-index of 0.912 for MPR. Notably, the MPR prediction Model 2, with a threshold cut-off of 0.74, exhibited 92.7% specificity and greater than 70% sensitivity, indicating a low rate of underestimating residual tumors. In conclusion, our study demonstrated the high accuracy of clinical assessment-based models in pathologic response prediction, aiding in decision-making regarding organ preservation and radiotherapy adjustments after induction immunochemotherapy.

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Section: Discussionsupporting

confidence: 86%

Enhancing Prediction for Tumor Pathologic Response to Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Cancer by Dynamic Parameters from Clinical Assessments

Song,

Liu,

et al. 2023

Cancers

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“…Furthermore, the τ value of the binary variable has a theoretical upper limit of 0.75; hence, there is also the problem that a high value cannot be obtained. It was reported previously that pathological grade is a reliable predictor of prognosis 39 , and that endoscopic response is correlated with prognosis 40 . In the future, early postoperative outcomes, such as pCR, may be used as the primary endpoint to shorten the duration of clinical trials, such as phase II trials.…”

Section: Discussionmentioning

confidence: 96%

Recurrence-free survival as a surrogate endpoint for overall survival after neoadjuvant chemotherapy and surgery for oesophageal squamous cell carcinoma

Okui,

Nagashima,

Matsuda

et al. 2024

British Journal of Surgery

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Background Overall survival is considered as one of the most important endpoints of treatment efficacy but often requires long follow-up. This study aimed to determine the validity of recurrence-free survival as a surrogate endpoint for overall survival in patients with surgically resectable advanced oesophageal squamous cell carcinoma (OSCC). Methods Patients with OSCC who received neoadjuvant cisplatin and 5-fluorouracil, or docetaxel, cisplatin and 5-fluorouracil, at 58 Japanese oesophageal centres certified by the Japan Esophageal Society were reviewed retrospectively. The correlation between recurrence-free and overall survival was assessed using Kendall's τ. Results The study included 3154 patients. The 5-year overall and recurrence-free survival rates were 56.6 and 47.7% respectively. The primary analysis revealed a strong correlation between recurrence-free and overall survival (Kendall's τ 0.797, 95% c.i. 0.782 to 0.812) at the individual level. Subgroup analysis showed a positive relationship between a more favourable pathological response to neoadjuvant chemotherapy and a higher τ value. In the meta-regression model, the adjusted R2 value at the institutional level was 100 (95% c.i. 40.2 to 100)%. The surrogate threshold effect was 0.703. Conclusion There was a strong correlation between recurrence-free and overall survival in patients with surgically resectable OSCC who underwent neoadjuvant chemotherapy, and this was more pronounced in patients with a better response to neoadjuvant chemotherapy.

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Remarkable response as a new indicator for endoscopic evaluation of local efficacy of non-surgical treatments for esophageal cancer

Yano,

Hayashi,

Ishihara

et al. 2024

Esophagus

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Prognostic impact of endoscopic response evaluation after neoadjuvant chemotherapy for esophageal squamous cell carcinoma: a nationwide validation study

Cited by 5 publications

References 36 publications

Enhancing Prediction for Tumor Pathologic Response to Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Cancer by Dynamic Parameters from Clinical Assessments

Enhancing Prediction for Tumor Pathologic Response to Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Cancer by Dynamic Parameters from Clinical Assessments

Recurrence-free survival as a surrogate endpoint for overall survival after neoadjuvant chemotherapy and surgery for oesophageal squamous cell carcinoma

Remarkable response as a new indicator for endoscopic evaluation of local efficacy of non-surgical treatments for esophageal cancer

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