Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy: a questionnaire survey in Japan

Aoyama, Norio; Koizumi, Hiroyoshi; Minamide, Junji; Yoneyama, Katsuya; Isono, Kaichi

doi:10.1007/pl00012095

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…It was suggested that the smaller the tumor, the greater the effect of CRT for esophageal cancer. Moreover, factor T was reported to be related to disease-free survival after combined 5-FU and radiation [28] and also after neoadjuvant CRT for esophageal cancer [29], Therefore, factor T is suggested to affect strongly the response after CRT for esophageal cancer.…”

Section: Discussionmentioning

confidence: 98%

Scoring System for Predicting Response to Chemoradiotherapy, Including 5-Fluorouracil and Platinum, for Patients with Esophageal Cancer

et al. 2008

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We have retrospectively evaluated clinical data before therapy to enable reliable prediction of the response of esophageal cancer to chemoradiotherapy (CRT). We analyzed 108 patients who received 5-fluorouracil and platinum combined with 60 Gy radiation for esophageal cancer. Factors significantly related to response were extracted by use of logistic regression analysis, and a response score (RS) was prepared by combining these factors. By multivariate analysis, nutritional status, T stage, M stage, and alkaline phosphatase were selected as significant factors that contributed independently to the response of esophageal cancer to CRT (P < 0.05). The odds ratios of the four selected factors was approximated and scored. The group with a high RS was found to include patients with complete response with a significantly higher frequency than the group with a low score (72.7% vs. 14.8%, P < 0.001). The RS is suggested to be an appropriate scoring system with which to predict response for these patients.

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Section: Discussionmentioning

confidence: 98%

Scoring System for Predicting Response to Chemoradiotherapy, Including 5-Fluorouracil and Platinum, for Patients with Esophageal Cancer

et al. 2008

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“…31,37,38 Patients with esophageal carcinoma who achieve a complete response with neoadjuvant therapy have a significantly improved survival. 39,40 Induction chemotherapy prior to CRT 41,42 can be an effective means of improving outcome. In a previous report Jin et al 41 showed that the rate of pathologic complete response was 37% in patents treated with induction chemotherapy followed by CRT and surgery, whereas it was only 11% in patients treated with CRT and surgery.…”

Section: Discussionmentioning

confidence: 99%

Reduction rate of lymph node metastasis as a significant prognostic factor in esophageal cancer patients treated with neoadjuvant chemoradiation therapy

Aiko

Yoshizumi

Ishizuka

et al. 2007

Diseases of the Esophagus

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Tumor regression is used widely as a measure of tumor response following radiation therapy or chemoradiation therapy (CRT). In cases of esophageal cancer, a different pattern of tumor shrinkage is often observed between primary tumors and metastatic lymph nodes (MLNs). Regression of MLNs surrounded by normal tissue may be a more direct measure of the response to CRT than regression of a primary tumor as exfoliative mechanical clearance does not participate in shrinkage of MLNs. In this study we evaluated the significance of the reduction rate (RR) of MLNs as a prognostic factor in esophageal cancer patients treated with neoadjuvant CRT. Forty-two patients with marked MLNs were selected from 93 patients with esophageal carcinoma who had received neoadjuvant CRT. The RRs of the primary tumor and the MLNs were calculated from computed tomography scans. In 20 patients, surgical resection was carried out following CRT. Univariate analysis was used to determine which of the following variables were related to survival: size of the primary tumor and MLNs; RRs of both lesions; degree of lymph node (LN) metastasis; clinical stage; and surgical resection. Multivariate analysis was then performed to assess the prognostic relevance of each variable. The primary tumor was larger than the MLNs in 69% of patients before CRT and in 40% of patients after CRT. In 79% of the patients, the RR of the primary tumor was greater than the RR of the MLNs. The results of the univariate analyses showed that a high RR of the MLNs and surgical resection after CRT were associated with significantly improved survival. The multivariate analysis demonstrated that the RR of MLNs had the strongest influence on survival. The RR of LN metastasis should be evaluated as an important prognostic predictor in patients with marked LN metastasis of esophageal cancer treated with CRT.

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“…Chemotherapy and radiation therapy especially have been the treatments used for patients with serious complications, invasion of adjacent structures or of advanced age 14,15 . Long‐term survival has been reported in patients who have undergone various treatments, but without surgery 16 . However, the actual rate of long‐term survival has not been demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…When patients with complete response to chemotherapy and/or radiotherapy were collected, the overall survival rate at 5 years was 64.8%. Therefore, if patients have complete response to chemotherapy and/or radiotherapy, a good prognosis can be expected, even if they have an advanced cancer 14,16,17 …”

Section: Discussionmentioning

confidence: 99%

Long-term survivors of advanced esophageal cancer without surgical treatment: a multicenter questionnaire survey in Kyushu, Japan

Natsugoe¹,

Ikeda²,

M³

et al. 2003

Diseases of the Esophagus

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Since the introduction of recent improvements in adjuvant therapy for esophageal cancer, some patients have demonstrated good prognosis. In the present study, we analyzed 3- and 5-year survivors of advanced esophageal cancer who did not undergo any surgical treatment. Between 1990 and 1998, 831 patients were admitted to 14 university hospitals and one cancer center associated with the membership of the Kyushu study group for adjuvant therapy of esophageal cancer. Twelve (1.4%) of the patients were 3-year survivors and 13 (1.6%) were 5-year survivors. The reasons for non-operation were refusal (eight patients), tumor-related factors (11 patients), and host-related factors (six patients). With a single exception, all patients had locally advanced tumors. Almost all long-term survivors had fewer than five lymph node metastases, in regions limited to the neck and/or mediastinum. Radiation therapy was combined with chemotherapy for 16 of the 25 patients, and chemotherapy-based cisplatin was used for 15 of these 16 patients. Fifteen of the patients remain alive; 10 died seven of them from esophageal cancer. Chemoradiation therapy was effective for some patients with locally advanced esophageal cancer, particularly in the absence of or with few lymph node metastases. To improve the prognosis of patients with advanced esophageal cancer who, for various causes, cannot undergo surgical treatment, a new protocol for adjuvant therapy is required.

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Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy: a questionnaire survey in Japan

Cited by 10 publications

References 19 publications

Scoring System for Predicting Response to Chemoradiotherapy, Including 5-Fluorouracil and Platinum, for Patients with Esophageal Cancer

Scoring System for Predicting Response to Chemoradiotherapy, Including 5-Fluorouracil and Platinum, for Patients with Esophageal Cancer

Reduction rate of lymph node metastasis as a significant prognostic factor in esophageal cancer patients treated with neoadjuvant chemoradiation therapy

Long-term survivors of advanced esophageal cancer without surgical treatment: a multicenter questionnaire survey in Kyushu, Japan

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