Pathologic Complete Response (Ypt0 Ypn0) After Chemotherapy and Radiotherapy Neoadjuvant Followed by Esophagectomy in the Squamous Cell Carcinoma of the Esophagus

Andreollo, Nelson Adami; Beraldo, Giovanni de Carvalho; Alves, Iuri Pedreira Filardi; Tercioti-Junior, Valdir; Ferrer, José Antonio Possato; Coelho-Neto, João de Souza; Lopes, Luiz Roberto

doi:10.1590/0102-672020180001e1405

Cited by 5 publications

(5 citation statements)

References 44 publications

(56 reference statements)

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“…Esophageal cancer is a growing health issue expected to increase in incidence over the next years due to the upsurge of gastroesophageal reflux disease and obesity 4 , 15 . It is still a challenging disease with a poor prognosis despite the advances in chemoradiotherapy 2 and all the progress made in the last years in minimally invasive surgery and postoperative management 19 .…”

Section: Introductionmentioning

confidence: 99%

Transhiatal Esophagectomy Is Not Associated With Poor Quality Lymphadenectomy

Takeda

Tustumi

Nigro

et al. 2019

ABCD, arq. bras. cir. dig.

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Background:Esophageal cancer neoadjuvant therapy followed by surgery increases the likelihood of treatment success. Aim:To evaluate variables that can influence the number of retrieved lymph nodes, the number of retrieved metastatic lymph nodes and lymphnodal recurrence in esophagectomy after neoadjuvant chemoradiotherapy. Methods:Patients of a single institute were evaluated after completion of trimodal therapy. Univariate and multivariate analyses were performed to evaluate variables that can influence in the number of retrieved lymph nodes and retrieved metastatic lymph nodes. Results:One hundred and forty-nine patients were included. Thoracoscopy access was considered an independent factor for the number of lymph nodes retrieved, but was neither related to the number of positive lymph nodes retrieved nor to lymphnodal recurrence. Pathological complete response on the primary tumor and male were independent variables associated with the number of positive lymph node retrieved. Pathological complete response on the primary tumor site did not statistically influence the likelihood of a lower number of lymph nodes retrieved. Conclusion:Patients submitted to esophagectomy after neoadjuvant chemoradiotherapy, thoracoscopic access is more accurate for pathological staging, even in a complete pathological response. With a proper patient selection, transhiatal surgery may preserve the quality of lymphadenectomy of the positive lymph nodes.

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Section: Introductionmentioning

confidence: 99%

Transhiatal Esophagectomy Is Not Associated With Poor Quality Lymphadenectomy

Takeda

Tustumi

Nigro

et al. 2019

ABCD, arq. bras. cir. dig.

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“…Comparing the survival curves of the two groups, there was no statistically significant difference between the two groups (p> 0.05). However, patients undergoing chemoradiotherapy had a longer survival time after 60 months of follow-up (52% versus 23%) 4 .…”

Section: Discussionmentioning

confidence: 96%

“…The several advantages, such as those mentioned above, are notorious, especially when compared to other types of treatments carried out together or isolated. There is a higher rate of R0 resections, in addition to the possibility of a complete response to neoadjuvant therapy, that is, a complete absence of tumor cells in the surgical specimen 4,5,11,12,13,15,20,21,27 .…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant Chemoradiotherapy Followed by Transhital Esophagectomy in Locally Advanced Esophageal Squamous Cell Carcinoma: Impact of Pathological Complete Response

Pereira

2021

ABCD, arq. bras. cir. dig.

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Background Multimodal therapy with neoadjuvant chemoradiotherapy, followed by esophagectomy has offered better survival results, compared to isolated esophagectomy, in advanced esophageal cancer. In addition, patients who have a complete pathological response to neoadjuvant treatment presented greater overall survival and longer disease-free survival compared to those with incomplete response. Aim: To compare the results of overall survival and disease-free survival among patients with complete and incomplete response, submitted to neoadjuvant chemoradiotherapy, with two therapeutic regimens, followed by transhiatal esophagectomy. Methods: Retrospective study, approved by the Research Ethics Committee, analyzing the medical records of 56 patients with squamous cell carcinoma of the esophagus, divided into two groups, submitted to radiotherapy (5040 cGY) and chemotherapy (5-Fluorouracil + Cisplatin versus Paclitaxel + Carboplatin) neoadjuvants and subsequently to surgical treatment, in the period from 2005 to 2012, patients. Results The groups did not differ significantly in terms of gender, race, age, postoperative complications, disease-free survival and overall survival. The 5-year survival rate of patients with incomplete and complete response was 18.92% and 42.10%, respectively (p> 0.05). However, patients who received Paclitaxel + Carboplatin, had better complete pathological responses to neoadjuvant, compared to 5-Fluorouracil + Cisplatin (47.37% versus 21.62% - p = 0.0473, p <0.05). Conclusions There was no statistical difference in overall survival and disease-free survival for patients who had a complete pathological response to neoadjuvant. Patients submitted to the therapeutic regimen with Paclitaxel and Carboplastin, showed a significant difference with better complete pathological response and disease progression. New parameters are indicated to clarify the real value in survival, from the complete pathological response to neoadjuvant, in esophageal cancer.

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“…Acreditava-se que a bactéria Helicobacter pylori exercia, na mucosa gástrica, um papel importante na formação carcinogênica, enquanto que, a sua ação direta na mucosa esofágica não era evidente. Entretanto, evidências têm indicado que a infecção pela bactéria exerce papel na patogênese de doenças do aparelho digestivo e dentre elas encontra-se o adenocarcinoma de esôfago (Andreollo et al, 2018).…”

Section: Discussionunclassified

Metaplasia e lesões histopatológicas de mucosa esofágica

Moura

Souza

Trindade

et al. 2022

RSD

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A metaplasia é um processo adaptativo reversível, que acontece em um tipo de célula que, mediante um estímulo, passa pela substituição de outro tipo celular de linhagem semelhante. Objetivo: identificar a prevalência de metaplasia e a sua relação com lesões histopatológicas encontradas em amostras de mucosa esofágica. Método: estudo transversal, retrospectivo com uma amostra de 1953 laudos histopatológicos de mucosa esofágica. Resultados: de 1953 laudos, 548 (28,1%) tinham metaplasia, sendo 94 (17,1%) do tipo intestinal e destes 35(6,4%) focal; 133(6,8%) tinham esôfago de Barrett, 414 (75,5%) com ectopia gástrica, 21 (1,1%) com displasia, sendo 12 (57,1%) de baixo grau e 9 (42,9%) alto grau e 1427 (73,1%) laudos apresentaram esofagite. A faixa etária mediana dos portadores de metaplasia foi de 45 anos (IIQ 34-55), sendo 289 (51,7%) do sexo feminino e 438 (81,4%) procedentes da capital. Dos laudos com metaplasia, 46 (8,2%) tinham Helicobacter pylori, 30 (5,3%) esôfago de Barrett e 14 (2,6%) com atrofia gástrica associada a bactéria, entretanto não houve associação significativa com a H.pylori. Foi estatisticamente significativo (p<0,001) a associação de metaplasia com esofagite, esofagite eosinofílica e pólipo adenomatoso. Conjuntamente, observamos um menor risco de metaplasia na presença de esofagite (RR: 0,44; IC95%: 0,36-0,55) e maior na presença de Eosinófilos >=15 eos/ CGA (RR: 3,27; IC95%: 1,70-6,62). Conclusão: Não temos evidências de relação entre metaplasia no esófago e H.pylori. A ausência de esofagite e a presença de Eosinófilos >=15 eos/ CGA está associado a um maior risco de transformação metaplásica.

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Pathologic Complete Response (Ypt0 Ypn0) After Chemotherapy and Radiotherapy Neoadjuvant Followed by Esophagectomy in the Squamous Cell Carcinoma of the Esophagus

Cited by 5 publications

References 44 publications

Transhiatal Esophagectomy Is Not Associated With Poor Quality Lymphadenectomy

Transhiatal Esophagectomy Is Not Associated With Poor Quality Lymphadenectomy

Neoadjuvant Chemoradiotherapy Followed by Transhital Esophagectomy in Locally Advanced Esophageal Squamous Cell Carcinoma: Impact of Pathological Complete Response

Metaplasia e lesões histopatológicas de mucosa esofágica

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