A multifactorial histopathologic score for the prediction of prognosis of resected esophageal adenocarcinomas after neoadjuvant chemotherapy.

Langer, R; Becker, K; Zlobec, I; Gertler, R; Sisic, L; Büchler, M; Lordick, F; Slotta-Huspenina, J; Weichert, W; Höfler, H; Feith, M; Ott, K

doi:10.1245/s10434-013-3410-y

2014

Zurück
Zurück zum Anfang der Trefferliste
Dauerhafter Link zum angezeigten Objekt

Titel:: A multifactorial histopathologic score for the prediction of prognosis of resected esophageal adenocarcinomas after neoadjuvant chemotherapy.
Dokumenttyp:: Journal Article
Autor(en):: Langer, R; Becker, K; Zlobec, I; Gertler, R; Sisic, L; Büchler, M; Lordick, F; Slotta-Huspenina, J; Weichert, W; Höfler, H; Feith, M; Ott, K
Abstract:: For esophageal adenocarcinoma treated with neoadjuvant chemotherapy, postoperative staging classifications initially developed for non-pretreated tumors may not accurately predict prognosis. We tested whether a multifactorial TNM-based histopathologic prognostic score (PRSC), which additionally applies to tumor regression, may improve estimation of prognosis compared with the current Union for International Cancer Control/American Joint Committee on Cancer (UICC) staging system.We evaluated esophageal adenocarcinoma specimens following cis/oxaliplatin-based therapy from two separate centers (center 1: n = 280; and center 2: n = 80). For the PRSC, each factor was assigned a value from 1 to 2 (ypT0-2 = 1 point; ypT3-4 = 2 points; ypN0 = 1 point; ypN1-3 = 2 points; <=50 % residual tumor/tumor bed = 1 point; >50 % residual tumor/tumor bed = 2 points). The three-tiered PRSC was based on the sum value of these factors (group A: 3; group B: 4-5; group C: 6) and was correlated with patients' overall survival (OS).The PRSC groups showed significant differences with respect to OS (p < 0.0001; hazard ratio [HR] 2.2 [95 % CI 1.7-2.8]), which could also be demonstrated in both cohorts separately (center 1 p < 0.0001; HR 2.48 [95 % CI 1.8-3.3] and center 2 p = 0.015; HR 1.7 [95 % CI 1.1-2.6]). Moreover, the PRSC showed a more accurate prognostic discrimination than the current UICC staging system (p < 0.0001; HR 1.15 [95 % CI 1.1-1.2]), and assessment of two goodness-of-fit criteria (Akaike Information Criterion and Schwarz Bayesian Information Criterion) clearly supported the superiority of PRSC over the UICC staging.The proposed PRSC clearly identifies three subgroups with different outcomes and may be more helpful for guiding further therapeutic decisions than the UICC staging system.
Zeitschriftentitel:: Ann Surg Oncol
Jahr:: 2014
Band / Volume:: 21
Heft / Issue:: 3
Seitenangaben Beitrag:: 915-21
Sprache:: eng
Volltext / DOI:: doi:10.1245/s10434-013-3410-y
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/24281419
Print-ISSN:: 1068-9265
TUM Einrichtung:: Chirurgische Klinik und Poliklinik; Institut für Allgemeine Pathologie und Pathologische Anatomie
BibTeX