Prognostic significance of endoluminal ultrasound-defined disease length and tumor volume (EDTV) for patients with the diagnosis of esophageal cancer

Twine, Christopher P.; Roberts, S. A.; Lewis, Wyn G.; Dave, Bella; Rawlinson, C.; Chan, David; Robinson, Mark; Crosby, Tom

doi:10.1007/s00464-009-0681-2

Cited by 25 publications

(7 citation statements)

References 42 publications

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“…The primary esophageal tumor was assessed, together with an evaluation of the para‐esophageal anatomical structures as described previously 7 . Malignant lymphadenopathy was defined by the following criteria: hypo echoic pattern, spherical contour, the presence of a distinct border, and a short axis diameter of 6 mm or more as previously described 8,9 . Individual nodes were counted during the initial examination.…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of the endoscopic ultrasound defined lymph node metastasis count in esophageal cancer

Twine

Roberts

Rawlinson

et al. 2010

Diseases of the Esophagus

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The key prognostic factor which predicts outcome after esophagectomy for cancer is the number of malignant lymph node metastases, but data regarding the accuracy of endoscopic ultrasound (EUS) in determining and predicting the metastatic lymph node count preoperatively are limited. The aim of this study was to assess the prognostic significance of EUS defined lymph node metastasis count (eLNMC) in patients diagnosed with esophageal cancer. Two hundred and sixty-seven consecutive patients (median age 63 years, 187 months) underwent specialist EUS followed by stage directed multidisciplinary treatment (183 esophagectomy [64 neoadjuvant chemotherapy, 19 neoadjuvant chemoradiotherapy], 79 definitive chemoradiotherapy, and 5 palliative therapy). The eLNMC was subdivided into four groups (0, 1, 2 to 4, >4) and the primary measure of outcome was survival. Survival was related to EUS tumor (T) stage (P < 0.0001), EUS node (N) stage (P < 0.0001), EUS tumor length (p < 0.0001), and eLNMC (P < 0.0001). Multivariable analysis revealed EUS tumor length (hazard ratio [HR] 1.071, 95% CI 1.008-1.138, P= 0.027) and eLNMC (HR 1.302, 95% CI 1.133-1.496, P= 0.0001) to be significantly and independently associated with survival. Median and 2-year survival for patients with 0, 1, 2-4, and >4 lymph node metastases were: 44 months and 71%, 36 months and 59%, 24 months and 50%, and 17 months and 32%, respectively. The total number of EUS defined lymph node metastases was an important and significant prognostic indicator.

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Section: Methodsmentioning

confidence: 99%

Prognostic significance of the endoscopic ultrasound defined lymph node metastasis count in esophageal cancer

Twine

Roberts

Rawlinson

et al. 2010

Diseases of the Esophagus

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“…Nevertheless, numerous authors have attempted to demonstrate the prognostic role of EUS in esophageal cancer treated with CRT by measuring the radial tumor thickness [30], total disease length [31], tumor volume [32], or tumor area [16,29,33,34,35]. …”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have attempted to determine the prognostic role of EUS for esophageal cancer treated with CRT by measuring the radial tumor thickness [30], total disease length [31], tumor volume [32] or tumor area [16,29,33,34,35]. In particular, a reduction in the cross-sectional area of tumor measured by EUS predicts the histopathologic response and prognosis in patients with esophageal cancer treated by neoadjuvant CRT [16,29,33,34,35].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Shim¹,

Song

Lee

et al. 2014

Digestion

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Background: Definitive chemoradiotherapy (CRT) is a reasonable approach for patients with locally advanced esophageal cancer who are not surgical candidates. This study was performed to investigate whether endosonography (EUS) assessment of tumor area response is a useful prognostic marker in patients with squamous cell carcinoma (SCC) of the esophagus who receive definitive CRT. Methods: A total of 33 patients who received definitive CRT for locally advanced esophageal SCC were enrolled. The maximal transverse cross-sectional area of the tumor was measured before and after definitive therapy. EUS response was defined as a ≥50% reduction of the tumor area after definitive CRT. Results: Based on EUS evaluation, there were 20 nonresponders (60.6%) and 13 responders (39.4%). The median progression-free survival (PFS) was significantly longer in EUS responders than EUS nonresponders (p = 0.005). However, there was no statistical significance in overall survival according to EUS response (p = 0.120). During multivariate analysis, EUS response to definitive CRT was the only significant factor associated with PFS (p = 0.045), whereas EUS response to definitive CRT was not associated with overall survival (p = 0.221). Conclusions: A reduction of the maximal cross-sectional tumor area measured by EUS correlates with a superior prognosis in patients with locally advanced SCC of the esophagus after definitive CRT.

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“…Ungeachtet von Ungenauigkeiten in der Zuordnung individueller T-und N-Stadien [69,72,73] gelingt die prognostisch entscheidende Differenzierung zwischen lokal begrenzten (T1N0, T 2N0) und fortgeschrittenen Karzinomen (≥ T3 und/oder N1 -N3 und/oder M1) endosonografisch mit hoher Sicherheit [69] und erlaubt die Zuordnung zu verschiedenen therapeutischen Kategorien. Die endosonografisch nachgewiesene Anzahl und Lokalisation von Lymphknotenmetastasen [36,38,59] ist ebenso prognostisch relevant wie die endosonografisch gemessene Tumorlänge [36,59], das aus Tumorlänge und maximaler Tumordicke errechnete Tumorvolumen [58] und der Nachweis von kleinen pleuralen, perikardialen und peritonealen Flüssigkeitsansammlungen [74]. Mehrere Studien haben aufzeigen können, dass das endosonografische Staging wahrscheinlich durch Verbesserung stadienadaptierter Therapieentscheidungen die Prognose der untersuchten Patienten positiv beeinflusst [38,53,75] und kosteneffektiv ist [76].…”

Section: öSophaguskarzinomunclassified

Maligne Neoplasien des Verdauungstrakts - neue Aspekte zum endosonografischen Staging

Jenssen

Dietrich²,

Burmester³

2011

Z Gastroenterol

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Prognostic significance of endoluminal ultrasound-defined disease length and tumor volume (EDTV) for patients with the diagnosis of esophageal cancer

Abstract: In this study, EDTV based on total EUS-defined length of disease emerged as a new and important prognostic indicator for patients with esophageal cancer.

Cited by 25 publications

References 42 publications

Prognostic significance of the endoscopic ultrasound defined lymph node metastasis count in esophageal cancer

Prognostic significance of the endoscopic ultrasound defined lymph node metastasis count in esophageal cancer

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Maligne Neoplasien des Verdauungstrakts - neue Aspekte zum endosonografischen Staging

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