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- Titel:
The clinical impact of histopathologic response assessment by residual tumor cell quantification in esophageal squamous cell carcinomas.
- Dokumenttyp:
- Journal Article; Article
- Autor(en):
- Brücher, BL; Becker, K; Lordick, F; Fink, U; Sarbia, M; Stein, H; Busch, R; Zimmermann, F; Molls, M; Höfler, H; Siewert, JR
- Abstract:
- BACKGROUND: The objectives of this study were to investigate histomorphologic features as a response classification after neoadjuvant radiochemotherapy (RTx/CTx) and to correlate the results with clinical outcome parameters (e.g., postoperative morbidity and mortality, recurrence, and survival) in patients with locally advanced esophageal squamous cell carcinoma (ESCC). METHODS: Three hundred eleven patients with histologically proven, locally advanced, intrathoracic ESCC (clinical T3 or T4, N0-N+, M0) located at or above the level of the tracheal bifurcation underwent preoperative, combined, simultaneous RTx/CTx followed by esophagectomy. Response to RTx/CTx was classified by the quantification of residual tumor cells. A histopathologic response was defined as <10% residual tumor cells found within the specimen compared with a histopathologic nonresponse, which was characterized by >10% residual tumor cells. RESULTS: A histopathologic response was correlated significantly with complete tumor resection status (R0 resection) (P .0001), histopathologic tumor (ypT) category (P <.0001), lymph node involvement (P <.0001), lymphatic vessel invasion (P <.001), and survival (P <.0001). A multivariate Cox regression analysis revealed that histopathologic response classification according to the percentage of residual tumor cells was an independent prognostic factor (P <.0001). Nonresponders had greater postoperative pulmonary morbidity (P = .01), a greater 30-day mortality rate (P = .02), and a dismal survival rate compared to histopathologic responders (P <.0001). CONCLUSIONS: Histopathologic response evaluation based on the quantification of residual tumor cells provided meaningful information for the assessment of outcomes among patients with ESCC who have underwent neoadjuvant RTx/CTx. The current results indicated that histopathologic responders may represent a subgroup of patients who benefit from neoadjuvant therapy followed by surgery.
- Zeitschriftentitel:
- Cancer
- Jahr:
- 2006
- Band / Volume:
- 106
- Heft / Issue:
- 10
- Seitenangaben Beitrag:
- 2119-27
- Sprache:
- eng
- Volltext / DOI:
- doi:10.1002/cncr.21850
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/16607651
- Print-ISSN:
- 0008-543X
- TUM Einrichtung:
- Chirurgische Klinik und Poliklinik; III. Medizinische Klinik und Poliklinik (Hämatologie / Onkologie); Institut für Allgemeine Pathologie und Pathologische Anatomie; Institut für Medizinische Statistik und Epidemiologie; Klinik und Poliklinik für RadioOnkologie und Strahlentherapie
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Vorkommen:
- mediaTUM GesamtbestandEinrichtungenSchools TUM School of Medicine and HealthDepartmentsClinical MedicineKlinik und Poliklinik für Chirurgie (Prof. Friess)2006
- mediaTUM GesamtbestandEinrichtungenSchools TUM School of Medicine and HealthDepartmentsClinical MedicineKlinik und Poliklinik für RadioOnkologie und Strahlentherapie (Prof. Combs)2006
- mediaTUM GesamtbestandEinrichtungenSchools TUM School of Medicine and HealthDepartmentsClinical MedicineInstitut für KI und Informatik in der Medizin (Prof. Rückert)2006