Pathological complete response in patients with esophageal cancer after the trimodality approach: The association with baseline variables and survival—The University of Texas MD Anderson Cancer Center experience

Murphy, Mariela Blum; Xiao, Lianchum; Patel, Viren; Maru, Dipen M.; Correa, Arlene M.; Amlashi, Fatemeh G.; Liao, Zhongxing; Komaki, Ritsuko; Lin, Steven H.; Skinner, Heath D.; Vaporciyan, Ara A.; Walsh, Garrett L.; Swisher, Stephen G.; Sepesi, Boris; Lee, Jeffrey H.; Bhutani, Manoop S.; Weston, Brian; Hofstetter, Wayne L.; Ajani, Jaffer A.

doi:10.1002/cncr.30953

Cited by 140 publications

(128 citation statements)

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“…Certain clinical factors are associated with lower or higher probability of pCR. Among clinical factors associated with lower pCR are older age (>60), poorly differentiated histology, presence of signet ring cells, higher T stage, and adenocarcinoma subtype [13]. Based on the findings of this study, other than the histological subtype, the patient had none of these oncologic factors, which in retrospect indicated a relatively high pretreatment probability of pCR.…”

Section: Discussionmentioning

confidence: 57%

“…Locally advanced esophageal cancer patients have the option of undergoing triple therapy which includes concurrent neoadjuvant chemoradiation followed by esophageal resection [12]. A minority subset of patients undergoing triple therapy may achieve pathologically complete response (pCR) with studies indicating a range of 19-30% with a lower rate in adenocarcinoma [13][14][15][16][17][18][19][20]. Such patients enjoy favorable prognoses compared to their non-pCR achieving counterparts in terms of recurrence-free survival and overall survival [14,[21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Pathologically Complete Response after Triple Therapy in Locally Advanced Esophageal Cancer in a Hereditary Hemorrhagic Telangiectasia Patient

et al. 2020

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Hereditary hemorrhagic telangiectasia (HHT) is a disorder characterized by vascular manifestations including mucocutaneous and visceral telangiectasias and arteriovenous malformations. Herein we present the case of a relatively young patient with HHT with an incidentally discovered locally advanced esophageal cancer on endoscopic screening and pathologically complete response after neoadjuvant chemoradiation. This case highlights an unusual tumor response to chemoradiation in locally advanced esophageal cancer, and the surveillance care of HHT patients.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Pathologically Complete Response after Triple Therapy in Locally Advanced Esophageal Cancer in a Hereditary Hemorrhagic Telangiectasia Patient

et al. 2020

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“…This method is the standard approach in patients with grades IB, II, III and IVA cancer [6]. Based on the various clinical trials performed, this method of treatment has been approved and confirmed by first grade clinical evidence [7]. Based on gathered evidence, 15 to 30 percent of the patients treated with neoadjuvant chemotherapy show complete pathological remission, as so the tumor itself is completely treated and no longer exists.…”

Section: Introductionmentioning

confidence: 99%

Comparing Two Year Survival Rate of Esophageal Cancer Patients with and without Neoadjuvant Chemoradiotherapy Treatment

Sas¹,

Mahmodlou²,

Ebrahimi³

et al. 2018

Arch Med

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Aim: This study was designed with the aim of determining and comparing the two year survival rate of patients who had, and had not received neoadjuvant chemoradiotherapy. Methods:This analytical study, approved by the ethical committee of Urmia University of Medical Sciences, evaluated esophageal cancer patients who had undergone surgery in Imam Khomeini Hospital of Urmia, between the years 2011 and 2016. Subjects were analyzed as two groups: those who were treated with neoadjuvant methods (n=168) and those who had not received this treatment (n=112). Results:The most common symptom in patients was dysphagia in each group (90.4% versus 87.5%) and also the most common types of esophagus cancer in our study was SCC in each group (88% versus 91.07%). A significant variation concerning survival rates between the two groups were observed (P=0.031). According to the Kaplan Meier survival analysis, the average survival rate of the first group (received neoadjuvant chemoradiotherapy) was 42.96 ± 2.74 months and that of the second group (untreated) was 41 ± 3.12 months. It is revealed that a significant variation is present between the two year survival rates of the two study groups (P=0.03). A significant variation was observed between the two groups concerning two year survival rates (P=0.01). Conclusion:Considering the gathered results, our study reveals that pre-operational neoadjuvant chemoradiotherapy is beneficial for the survival rates of patients suffering from esophageal cancer, therefore we recommend that prior to performing invasive treatments, such as surgery, it is beneficial to provide chemoradiotherapy for these patients.

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“…But even patients who have attained a complete pathologic response to neoadjuvant chemoradiation frequently fail systemically, albeit less so than incomplete responders. 3 It is important to recognize that the presence of nodal disease and response to therapy is reflective of prognosis because it is an indicator of systemic disease. The problem is that we have yet to fully address hematogenous spread.…”

mentioning

confidence: 99%

Commentary: Maximizing response and outcomes in multimodality therapy for locally advanced esophageal adenocarcinoma

Hofstetter

2019

The Journal of Thoracic and Cardiovascular Surgery

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Pathological complete response in patients with esophageal cancer after the trimodality approach: The association with baseline variables and survival—The University of Texas MD Anderson Cancer Center experience

Cited by 140 publications

References 29 publications

Pathologically Complete Response after Triple Therapy in Locally Advanced Esophageal Cancer in a Hereditary Hemorrhagic Telangiectasia Patient

Pathologically Complete Response after Triple Therapy in Locally Advanced Esophageal Cancer in a Hereditary Hemorrhagic Telangiectasia Patient

Comparing Two Year Survival Rate of Esophageal Cancer Patients with and without Neoadjuvant Chemoradiotherapy Treatment

Commentary: Maximizing response and outcomes in multimodality therapy for locally advanced esophageal adenocarcinoma

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