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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
Titel:
The clinical impact of histopathologic response assessment by residual tumor cell quantification in esophageal squamous cell carcinomas.
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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