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Other version: http://www.mdconsult.com/das/article/body/332286515-2/jorg=journal%26source=%26sp=23363129%26sid=0/N/749826/s00165107...
Endosonographic radial tumor thickness after neoadjuvant chemoradiation therapy to predict response and survival in patients with locally advanced esophageal cancer: a prospective multicenter phase ll study by the Swiss Group for Clinical Cancer Research (SAKK 75/02)
|Published in||Gastrointestinal Endoscopy. 2010, vol. 71, no. 7, p. 1114-1121|
|Abstract||BACKGROUND: EUS response assessment in patients with locally advanced esophageal cancer undergoing neoadjuvant chemoradiation therapy (CRT) is limited by disintegration of the involved anatomic structures. OBJECTIVE: Predictive and prognostic values of a prospectively defined maximum tumor thickness (MTT). DESIGN: Prospective open-label phase ll study (SAKK 75/02). SETTING: Multicenter, nationwide. PATIENTS: Of 66 patients with primary CRT, 56 underwent en bloc esophagectomy. INTERVENTIONS: EUS-measured MTT before and 2-5 weeks after CRT (yMTT). MAIN OUTCOME MEASUREMENTS: Cutoffs: (1) absolute thickness (yMTT) after CRT ≤ 6 mm; (2) relative reduction compared with baseline (ratio yMTT/MTT) ≤ 50%. Correlation between EUS measurements and histopathologic tumor regression grade (TRG) and overall survival (OS). RESULTS: Sixteen of 56 patients were not included for EUS evaluation (10 severe stenosis, 5 MTT not measured, 1 intolerance to second EUS). Characteristics (n = 40) were as follow: median age, 60 years; squamous cell carcinoma, 42%; and adenocarcinoma (AC), 58%. Initial stage was: 10 T2N1, 3 T3N0, 26 T3N1, 1 T3Nx; 14 of 23 AC Siewert type 1. Wilcoxon rank sum test showed significant correlation of TRG1 with yMTT ≤ 6 mm (P = .008) and yMTT/MTT ≤ 50% (P = .003). The effect of yMTT on TRG1 was significant (P = .0193; odds ratio, 0.687 [95% CI, 0.502-0.941]). The predefined cutoff of ≤ 6 mm for yMTT was predictive for TRG1 (P = .0037; Fisher exact test). After a median follow-up of 28.6 months, there was a clear trend for benefit in OS with yMTT ≤ 6 mm and yMTT/MTT ≤ 50%. LIMITATIONS: Small sample size. CONCLUSION: In a multicenter setting, MTT measured by EUS after CRT was highly predictive for response and showed a clear trend for predicting survival.|
|Keywords||Adenocarcinoma/drug therapy/mortality/radiotherapy/ultrasonography — Adult — Aged — Antineoplastic Agents/therapeutic use — Carcinoma, Squamous Cell/drug therapy/mortality/radiotherapy/ultrasonography — Cisplatin/*therapeutic use — Disease Progression — Drug Therapy, Combination — Endosonography/*methods — Esophageal Neoplasms/drug therapy/mortality/radiotherapy/*ultrasonography — Esophagus/pathology/*ultrasonography — Female — Follow-Up Studies — Humans — Male — Middle Aged — Neoadjuvant Therapy — Neoplasm Staging/methods — Predictive Value of Tests — Prospective Studies — Radiation-Sensitizing Agents/therapeutic use — Survival Rate/trends — Taxoids/*therapeutic use — Treatment Outcome|
|Research group||Physiopathologie de la pancréatite aiguë (601)|
|JOST, Christian et al. Endosonographic radial tumor thickness after neoadjuvant chemoradiation therapy to predict response and survival in patients with locally advanced esophageal cancer: a prospective multicenter phase ll study by the Swiss Group for Clinical Cancer Research (SAKK 75/02). In: Gastrointestinal Endoscopy, 2010, vol. 71, n° 7, p. 1114-1121. https://archive-ouverte.unige.ch/unige:21029|