Correlation of EUS measurement with pathologic assessment of neoadjuvant therapy response in esophageal carcinoma

Willis, Joseph E.; Cooper, Gregory S.; Isenberg, Gerard; Sivak, Michael; Levitan, Nathan; Clayman, Julie; Chak, Amitabh

doi:10.1067/mge.2002.123273

Cited by 87 publications

(71 citation statements)

References 34 publications

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“…19 A response to therapy was defined as a reduction of cross-sectional area by 50%, and this was validated by Chak and colleagues, who also showed a survival benefit for patients who achieved this level of response. 16,18,20 Bowrey et al evaluated a similar group of patients and found the same inaccuracies and unreliability of EUS for restaging esophageal carcinoma after CRT that we found. Their conclusion was to use the maximum tumor depth, in millimeters, as the measure to follow when monitoring response to CRT.…”

Section: Discussionsupporting

confidence: 82%

“…The majority of patients in their study also were over staged during the restaging EUS examination, similar to our patients, especially in patients who achieved a complete response and in patients who had minimal disease. 17,18 Some studies have advocated defining the tumor by its size and cross-sectional area, rather than using the TNM classification system, as the primary means for following tumor response to therapy. Isenberg et al concluded that EUS after CRT was not accurate when using the TNM classification system but found that, if the maximal cross-sectional area was measured and followed, then this proved to be more useful.…”

Section: Discussionmentioning

confidence: 99%

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The accuracy of endoscopic ultrasound for restaging esophageal carcinoma after chemoradiation therapy

Kalha

Kaw

Fukami

et al. 2004

Cancer

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The study of fault detection and diagnosis of electrical machines, in particular induction motors, as well as the teaching of their behavior requires practical experience in this field. To provide this experience to the students this paper presents an experimental system that can be used with a standard industrial electrical induction machine. This system is based on only one healthy induction machine that is operated under faulty operating modes. Several fault types such as stator winding faults, bearing faults, or broken bars can be tested. The developed system also allows testing the behavior of the electrical machine for different load types. Several typical loads in which the torque depends of time or speed were implemented. The system is based on computer equipment with a DSPIC, a testing system and an induction machine. © 2010 Wiley Periodicals, Inc. Comput Appl Eng Educ 20: 611–618, 2012

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

The accuracy of endoscopic ultrasound for restaging esophageal carcinoma after chemoradiation therapy

Kalha

Kaw

Fukami

et al. 2004

Cancer

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“…In an exploratory analysis, we attempted to assess the potential of EUS as a tool for outcome prediction to preoperative chemotherapy, evaluating the change in maximal tumour thickness with a decrease of X30% representing a response, the cut-off value utilised in RECIST and a simple response classifier. Response according to EUS and its correlation with outcomes, such as pathological response and survival, has previously been shown in small studies of neoadjuvant therapy for oesophageal cancer (Hirata et al, 1997;Chak et al, 2000;Willis et al, 2002;Masaho et al, 2005). In our analysis, there was no difference in OS between EUS responders and non-responders to preoperative chemotherapy and is likely to reflect the small number of patients.…”

Section: Discussionmentioning

confidence: 82%

A phase II trial of preoperative chemotherapy with epirubicin, cisplatin and capecitabine for patients with localised gastro-oesophageal junctional adenocarcinoma

et al. 2009

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Preoperative cisplatin/fluorouracil is used for the treatment of localised oesophageal carcinoma. This phase II study aimed to assess the efficacy and safety of administering preoperative epirubicin/cisplatin/capecitabine (ECX). Patients with stage II or III oesophageal/ gastro-oesophageal junctional adenocarcinoma from one institution received 4 cycles of ECX (epirubicin 50 mg m À2 day 1, cisplatin 60 mg m À2 day 1, capecitabine 625 mg m À2 b.i.d. daily) followed by surgery. The primary end point was the pathological complete response (pCR) rate based on a Simon two-stage design. Secondary end points included overall and progression-free survival (OS/ PFS). Thirty-four patients were recruited: median age 60 years (range 41 -81), 91% male, 97% PS 0/1, 80% T3, 68% N1. Thirty-one patients completed four ECX cycles. Grade 3/4 toxicities X5% included neutropenia (62%), hand -foot syndrome (15%) and nausea/ vomiting (9%). Thirteen out of 28 (46%) evaluable patients responded to chemotherapy by EUS (X30% reduction in maximal tumour thickness). Twenty-six out of 34 (76%) patients underwent resection (R0 ¼ 73%, R1 ¼ 27%). Post-operatively, two patients died within 60 days of surgery. The pCR rate was 5.9% (95% CI 0 -14%) in the intent-to-treat population. According to the statistical design, this prompted early study termination. However, with a median follow-up of 34 months the median OS and 1-and 2-year survival rates were 17 months, 67 and 39% respectively. Median PFS was 13 months. Of the 14 relapsed patients, 10 presented with distant metastases. Preoperative ECX is feasible and well tolerated. Although associated with a low pCR rate, survival with ECX was comparable with published studies suggesting that pCR may not correlate with satisfactory outcome from preoperative chemotherapy for localised oesophageal adenocarcinoma.

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“…Previous studies have attempted to determine the prognostic role of EUS for esophageal cancer treated with CRT by measuring the radial tumor thickness [30], total disease length [31], tumor volume [32] or tumor area [16,29,33,34,35]. In particular, a reduction in the cross-sectional area of tumor measured by EUS predicts the histopathologic response and prognosis in patients with esophageal cancer treated by neoadjuvant CRT [16,29,33,34,35].…”

Section: Introductionmentioning

confidence: 99%

“…In particular, a reduction in the cross-sectional area of tumor measured by EUS predicts the histopathologic response and prognosis in patients with esophageal cancer treated by neoadjuvant CRT [16,29,33,34,35]. However, no studies have attempted to evaluate the relation between prognosis and the reduction of esophageal cross-sectional tumor area on EUS after definitive CRT.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Shim¹,

Song

Lee

et al. 2014

Digestion

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Background: Definitive chemoradiotherapy (CRT) is a reasonable approach for patients with locally advanced esophageal cancer who are not surgical candidates. This study was performed to investigate whether endosonography (EUS) assessment of tumor area response is a useful prognostic marker in patients with squamous cell carcinoma (SCC) of the esophagus who receive definitive CRT. Methods: A total of 33 patients who received definitive CRT for locally advanced esophageal SCC were enrolled. The maximal transverse cross-sectional area of the tumor was measured before and after definitive therapy. EUS response was defined as a ≥50% reduction of the tumor area after definitive CRT. Results: Based on EUS evaluation, there were 20 nonresponders (60.6%) and 13 responders (39.4%). The median progression-free survival (PFS) was significantly longer in EUS responders than EUS nonresponders (p = 0.005). However, there was no statistical significance in overall survival according to EUS response (p = 0.120). During multivariate analysis, EUS response to definitive CRT was the only significant factor associated with PFS (p = 0.045), whereas EUS response to definitive CRT was not associated with overall survival (p = 0.221). Conclusions: A reduction of the maximal cross-sectional tumor area measured by EUS correlates with a superior prognosis in patients with locally advanced SCC of the esophagus after definitive CRT.

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Correlation of EUS measurement with pathologic assessment of neoadjuvant therapy response in esophageal carcinoma

Cited by 87 publications

References 34 publications

The accuracy of endoscopic ultrasound for restaging esophageal carcinoma after chemoradiation therapy

The accuracy of endoscopic ultrasound for restaging esophageal carcinoma after chemoradiation therapy

A phase II trial of preoperative chemotherapy with epirubicin, cisplatin and capecitabine for patients with localised gastro-oesophageal junctional adenocarcinoma

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

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