Pathologic Response after Neoadjuvant Therapy is the Major Determinant of Survival in Patients with Esophageal Cancer

Meredith, Kenneth; Weber, Jill; Turaga, Kiran K.; Siegel, Erin M.; McLoughlin, James M.; Hoffe, Sarah E.; Melis, Marcovalerio; Shah, Nilay; Kelley, Scott T.; Karl, Richard C.

doi:10.1245/s10434-009-0862-1

Cited by 197 publications

(175 citation statements)

References 36 publications

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“…Patients with pCR in rectal specimens who received neoadjuvant chemoradiation have better disease-free and overall survival than patients with residual rectal adenocarcinoma [24][25][26][27][28][29]. Similarly, patients with pCR in esophagectomy specimens after neoadjuvant therapy also had better prognosis than those with residual disease [12,14]. In this study, we compared the disease-specific survival of 10 patients with pCR to those patients who had lymph node negative residual PDA (stage I and stage IIA) in pancreaticoduodenectomy after neoadjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

“…pCR has been shown to be associated with lower frequencies of local recurrence and better survival in patients with adenocarcinoma of several anatomic sites who received neoadjuvant therapies [10][11][12][13][14]. In patients with esophageal and gastroesophageal junction adenocarcinoma who received neoadjuvant therapy, 21.7% to 40.5% patients have been reported to have pCR in their subsequent esophagectomy specimens, and pCR is associated with better 5-year survival rate and lower risk of recurrence [12,14]. Similarly, the rates of pCR in patients with rectal cancer who received neoadjuvant therapy are reported to be 13% to 16% [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Pathologic complete response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma is associated with better prognosis

Wang¹,

Zhao²

2012

Annals of Diagnostic Pathology

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In patients with pancreatic ductal adenocarcinoma (PDA) who received neoadjuvant therapy and pancreatectomy, pathologic complete response (pCR) is rarely observed and the prognostic significance of pCR is not clear. In this study, we reported 11 patients with pCR (2.5%) from 442 patients with PDA who received neoadjuvant treatment and pancreatectomy from 1995 to 2010. There were 6 men and 5 women with median age of 61 years. Four patients had either synchronous or prior history of extra-pancreatic cancer. Five patients received neoadjuvant chemotherapy followed by chemoradiation, and 6 received chemoradiation alone. Ten patients had pancreaticoduodenectomy and one had distal pancreatectomy. Scar and chronic pancreatitis consistent with therapy effect were present in all cases (100%). Pancreatic intraepithelial neoplasia 3 (Pan IN3)/carcinoma in situ was present in 5 cases, PanIN1 and PanIN2 in 5 cases. However, no residual invasive carcinoma or lymph node metastasis was identified in all cases. Follow-up information was available in 10 patients. Follow-up time ranges from 6 to 194 months (median, 63 months). During follow-up, three patients died of other causes and one developed a second primary PDA in the tail of pancreas at 84 months after initial pancreaticoduodenectomy and died at 105 months after the initial diagnosis of PDA. The other 6 patients were alive with no evidence of disease. Patients with pCR had better survival than those who had post-therapy stage I or IIA

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathologic complete response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma is associated with better prognosis

Wang¹,

Zhao²

2012

Annals of Diagnostic Pathology

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“…Given the variety of patient responses to radiation treatment, the ability to predict response versus nonresponse would allow treatment to be individualized, thereby helping patients avoid unnecessary risks of toxicity and side effects if they are unlikely to benefit from radiotherapy (19,20). To distinguish between responders versus non-responders using miRNA profiling methods, distinct differences in miRNA expression profiles of tumors for each patient group must be present.…”

Section: Mirnas As Predictors Of Response To Radiotherapymentioning

confidence: 99%

MicroRNAs and Their Impact on Radiotherapy for Cancer

et al. 2016

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“…[10][11][12][13]15,20,21 In general, the margin-free resection rate or 6-month progression-free survival is used as an effective surrogate marker of NACRT efficacy in PDA. The pathological response rate is also gaining recognition as an important surrogate.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 For several different types of carcinoma, in some organs, pathological complete response (pCR) to neoadjuvant therapy is correlated with a lower frequency of local recurrence and better survival. [10][11][12][13][14][15] However, very few studies have analyzed the clinicopathological significance of pCR in patients with PDA who received neoadjuvant therapy. 9,16,17 Here we report two cases of pCR to NACRT in PDA, including detailed pathological findings of resected tissues.…”

Section: Introductionmentioning

confidence: 99%

Two Cases of Pathological Complete Response to Neoadjuvant Chemoradiation Therapy in Pancreatic Cancer

et al. 2015

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Neoadjuvant chemoradiation therapy (NACRT) is increasingly used in patients with a potentially or borderline resectable pancreatic ductal adenocarcinoma (PDA) and it has been shown to improve survival and reduce locoregional metastatic disease. It is rare for patients with PDA to have a pathological complete response (pCR) to NACRT, but such patients reportedly have a good prognosis. We report the clinicopathological findings of two cases of pCR to NACRT in PDA. Both patients underwent pancreatectomy after NACRT (5-fluorouracil, mitomycin C, cisplatin, and radiation). Neither had residual invasive carcinoma and both showed extensive fibrotic regions with several ducts regarded as having pancreatic intraepithelial neoplasia 3/carcinoma in situ in their post-therapy specimens. It is noteworthy that both patients had a history of a second primary cancer. They both had comparatively good outcomes: one lived for 9 years after the initial pancreatectomy and the other is still alive without recurrence after 2 years.

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Pathologic Response after Neoadjuvant Therapy is the Major Determinant of Survival in Patients with Esophageal Cancer

Abstract: Esophageal cancer patients frequently succumb to their disease. However, patients treated with neoadjuvant therapy who achieve pCR have a higher rate of R0 resections, fewer recurrences, and improved 5-year OS and DFS.

Cited by 197 publications

References 36 publications

Pathologic complete response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma is associated with better prognosis

Pathologic complete response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma is associated with better prognosis

MicroRNAs and Their Impact on Radiotherapy for Cancer

Two Cases of Pathological Complete Response to Neoadjuvant Chemoradiation Therapy in Pancreatic Cancer

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