EsophagusPreoperative prediction of a pathologic complete response of esophageal squamous cell carcinoma to neoadjuvant chemoradiotherapy
Section snippets
Patients
We reviewed 130 consecutive patients with ESCC who were evaluated preoperatively before and after NCRT using CT, PET, and endoscopy and who later underwent esophagectomy between October 2006 and December 2016. All histologic tumor types were diagnosed as squamous cell carcinoma from biopsy samples obtained before treatment. Table I shows the clinicopathologic characteristics of patients. The clinicopathologic profiles of the tumors (cStage, ycStage, and ypStage: c, y and p determined by
Assessment of ypT0 using endoscopy and PET after NCRT
Fifty-three (40.8%) and 49 (37.7%) patients achieved disappearance of the primary tumor by endoscopy and PET, respectively, and were associated with ypT0 (Table II , P = .01 and P = .001, respectively). Furthermore, 33 (25.4%) patients achieved ycT0 (clinical complete disappearance of the primary tumor evaluated by both endoscopy and PET after NCRT) and were associated with ypT0 (Table II, P = .001).
The sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values of
Discussion
Esophageal cancer was diagnosed in resected specimens from some patients who achieved a pCR after NCRT followed by esophageal resection. Furthermore, adding the esophagectomy after induction CRT does not appear to confer any benefit compared with continuing additional CRT when patients with locally advanced thoracic ESCC respond to induction CRT.14 Therefore, definitive CRT might be an alternative treatment for patients with ESCC who respond very well to NCRT. These findings provided a basis
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