Impact of CT-assessed changes in tumor size after neoadjuvant chemotherapy on pathological response and survival of patients with esophageal squamous cell carcinoma

Matsumoto, Sohei; Wakatsuki, Kohei; Nakade, Hiroshi; Kunishige, Tomohiro; Miyao, Shintaro; Tsujimoto, Akinori; Tatsumi, Takanari; Sho, Masayuki

doi:10.1007/s00423-022-02430-x

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…While pCR or major pathological response is achieved after neoadjuvant chemotherapy in combination with immunotherapy, longer disease-free survival and overall survival may be achieved because the immunotherapy response lasts longer [31] and micrometastases are eliminated [24] .Besides, the downstaging of 57.1% of primary tumors and the reduction in primary tumor size of 84.1% in this study were su cient to demonstrate the effectiveness of neoadjuvant chemotherapy combined with immunotherapy. Studies have shown that tumor diameter reduction after neoadjuvant therapy is an independent prognostic factor for relapse-free survival of esophageal cancer [32]. It also signi cantly reduces the di culty of performing radical surgery.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of neoadjuvant immunotherapy combined with chemotherapy for resectable locally advanced esophageal squamous cell carcinoma

Liu

Xing

et al. 2023

Preprint

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Background The aim of this study was to investigate the safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced resectable esophageal squamous cell carcinoma. Methods This study retrospectively analyzed 63 patients with esophageal squamous cell carcinoma who received neoadjuvant chemotherapy combined with immunotherapy in our hospital from January 2022 to January 2023. The characteristics of neoadjuvant therapy and surgery were analyzed to determine the safety and feasibility of neoadjuvant chemotherapy and immunotherapy. Results A total of 63 patients were included in the study. The most commonly used regimens of immunotherapy were camrelizumab (n = 35,55.56%), tislelizumab (n = 12,19.05%), pembrolizumab (n = 8,12.70%),and sintilimab (n = 8, 12.70%). A total of 12 patients (19.0%) experienced different grades of adverse events during neoadjuvant therapy. Grade 3 adverse events included Neutropenia (n = 2, 3.2%). Sixty of 63 patients completed minimally invasive surgical treatment, and only 3 patients were converted to thoracotomy. The PCR rate in this study was 11.1%. The downstaging of primary tumors is 57.1% and the reduction in primary tumor size is 84.1%. According to Clavien-Dindo, 14 patients (22.2%) suffered grade ≤ 3 perioperative complications and only 2 patients (3.2%) suffered grade > 3 perioperative complications. The most common complications were pneumonia and arrhythmia, which accounted for 14.3% and 6.3% respectively. Conclusions Neoadjuvant chemotherapy combined with immunotherapy is safe and effective for resectable locally advanced esophageal squamous cell carcinoma. Complications after neoadjuvant therapy and perioperative rates were also acceptable.

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Section: Discussionmentioning

confidence: 99%

Safety and feasibility of neoadjuvant immunotherapy combined with chemotherapy for resectable locally advanced esophageal squamous cell carcinoma

Liu

Xing

et al. 2023

Preprint

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“…As described above, most patients with cStage II or III disease undergo neoadjuvant treatment before esophagectomy. Although a significant positive correlation between the response of primary tumors to neoadjuvant treatment and patient survival is well known, 6 – 8) the primary tumor is not considered a target lesion in the response evaluation criteria for solid tumors (RECIST). 9) In the 12th edition, we introduced two new methods for evaluating primary tumor size using CT images: one uses the short diameter of the primary tumor, and the other uses the esophageal cross-sectional area.…”

Section: Details Problems and Prospects In Relation To Each Modificationmentioning

confidence: 99%

Review of the Japanese Classification of Esophageal Cancer 12th Edition, and Proposals for the 13th Edition

Mine

2024

ATCS

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“…[15][16][17] While these biomarkers have been identified as prognostic indicators for ESCC risk stratification and therapy decision-making, they overlook critical information on tumors. 18 Radiomics is a potentially valuable approach to extracting valuable data from computational medical images, providing a noninvasive option for assessing tumors and their immune microenvironment 19,20 as an alternative to biopsy. CT imaging is commonly utilized for cancer evaluation, particularly CECT for detecting primary tumors and lymph nodes in esophageal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

“…Alternately, some research focuses on using blood biomarkers to predict the response of ESCC patients to anti‐PD‐1 therapy 15–17 . While these biomarkers have been identified as prognostic indicators for ESCC risk stratification and therapy decision‐making, they overlook critical information on tumors 18 …”

Section: Introductionmentioning

confidence: 99%

Contrast‐enhanced CT‐based radiomic analysis for determining the response to anti‐programmed death‐1 therapy in esophageal squamous cell carcinoma patients: A pilot study

Yang,

Huang,

Zhang

et al. 2023

Thoracic Cancer

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BackgroundIn view of the fact that radiomics features have been reported as predictors of immunotherapy to various cancers, this study aimed to develop a prediction model to determine the response to anti‐programmed death‐1 (anti‐PD‐1) therapy in esophageal squamous cell carcinoma (ESCC) patients from contrast‐enhanced CT (CECT) radiomics features.MethodsRadiomic analysis of images was performed retrospectively for image samples before and after anti‐PD‐1 treatment, and efficacy analysis was performed for the results of two different time node evaluations. A total of 68 image samples were included in this study. Quantitative radiomic features were extracted from the images, and the least absolute shrinkage and selection operator method was applied to select radiomic features. After obtaining selected features, three classification models were used to establish a radiomics model to predict the ESCC status and efficacy of therapy. A cross‐validation strategy utilizing three folds was employed to train and test the model. Performance evaluation of the model was done using the area under the curve (AUC) of receiver operating characteristic, sensitivity, specificity, and precision metric.ResultsWavelet and area of gray level change (log‐sigma) were the most significant radiomic features for predicting therapy efficacy. Fifteen radiomic features from the whole tumor and peritumoral regions were selected and comprised of the fusion radiomics score. A radiomics classification was developed with AUC of 0.82 and 0.884 in the before and after‐therapy cohorts, respectively.ConclusionsThe combined model incorporating radiomic features and clinical CECT predictors helps to predict the response to anti‐PD‐1therapy in patients with ESCC.

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Impact of CT-assessed changes in tumor size after neoadjuvant chemotherapy on pathological response and survival of patients with esophageal squamous cell carcinoma

Cited by 5 publications

References 26 publications

Safety and feasibility of neoadjuvant immunotherapy combined with chemotherapy for resectable locally advanced esophageal squamous cell carcinoma

Safety and feasibility of neoadjuvant immunotherapy combined with chemotherapy for resectable locally advanced esophageal squamous cell carcinoma

Review of the Japanese Classification of Esophageal Cancer 12th Edition, and Proposals for the 13th Edition

Contrast‐enhanced CT‐based radiomic analysis for determining the response to anti‐programmed death‐1 therapy in esophageal squamous cell carcinoma patients: A pilot study

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