Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response

Pooja Rohatgi, Stephen C. Swisher, Arlene M. Correa, Tsung T. Wu, Zhongxing Liao, Ritsuko Komaki, Garrett L. Walsh, Ara A. Vaporciyan, David C. Rice, Jack A. Roth, Jaffer A. Ajani

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

BACKGROUND. The purpose of the current study was to test the hypothesis that a lower clinical TNM stage is associated with a higher rate of pathologic complete response (pathCR) in patients with esophageal carcinoma receiving preoperative chemoradiotherapy and to determine whether outcome after pathCR is related to clinical stage or treatment. METHODS. Clinical parameters and surgical specimens of patients with esophageal carcinoma undergoing preoperative chemoradiotherapy were analyzed to identify predictors of pathCR. In patients with pathCR, predictors of overall survival (OS), disease-free survival (DFS), and distant recurrence were studied. RESULTS. Sixty-nine (29%) of 235 patients achieved pathCR. In patients with American Joint Committee on Cancer (AJCC) Stage II carcinoma, the proportion achieving pathCR was significantly larger than that achieving <pathCR (65% vs. 35%; P = 0.03). The proportion of patients who received induction chemotherapy was higher in the pathCR group than in the <pathCR group (54% vs. 46%; P = 0.05). However, neither TNM classification, primary tumor location, histologic type, gender, therapy sequence, or radiation dose (45 grays [Gy] vs. 50.4 Gy) were found to have any influence on OS or DFS. The median OS from pathCR was significantly longer than that from <pathCR (133 mos vs. 34 mos; P = 0.002). Similarly, DFS was longer in the pathCR group than in the <pathCR (P = 0.001). CONCLUSIONS. Patients with clinical AJCC Stage II esophageal carcinoma are more likely to achieve a pathCR after preoperative chemoradiotherapy than are those with Stage III carcinoma. Chemoradiotherapy as primary therapy for patients with Stage I esophageal carcinoma warrants investigation as a means to preserve their esophagus.

Original languageEnglish (US)
Pages (from-to)2365-2372
Number of pages8
JournalCancer
Volume104
Issue number11
DOIs
StatePublished - Dec 1 2005
Externally publishedYes

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Chemoradiotherapy
Esophagus
Carcinoma
Disease-Free Survival
Survival
Neoplasms
Induction Chemotherapy
Neoplasm Staging
Therapeutics
Radiation
Recurrence

Keywords

  • Carcinoma
  • Esophagus
  • Pathologic complete response (pathCR)
  • Preoperative chemoradiation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response. / Rohatgi, Pooja; Swisher, Stephen C.; Correa, Arlene M.; Wu, Tsung T.; Liao, Zhongxing; Komaki, Ritsuko; Walsh, Garrett L.; Vaporciyan, Ara A.; Rice, David C.; Roth, Jack A.; Ajani, Jaffer A.

In: Cancer, Vol. 104, No. 11, 01.12.2005, p. 2365-2372.

Research output: Contribution to journalArticle

Rohatgi, P, Swisher, SC, Correa, AM, Wu, TT, Liao, Z, Komaki, R, Walsh, GL, Vaporciyan, AA, Rice, DC, Roth, JA & Ajani, JA 2005, 'Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response', Cancer, vol. 104, no. 11, pp. 2365-2372. https://doi.org/10.1002/cncr.21439
Rohatgi, Pooja ; Swisher, Stephen C. ; Correa, Arlene M. ; Wu, Tsung T. ; Liao, Zhongxing ; Komaki, Ritsuko ; Walsh, Garrett L. ; Vaporciyan, Ara A. ; Rice, David C. ; Roth, Jack A. ; Ajani, Jaffer A. / Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response. In: Cancer. 2005 ; Vol. 104, No. 11. pp. 2365-2372.
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abstract = "BACKGROUND. The purpose of the current study was to test the hypothesis that a lower clinical TNM stage is associated with a higher rate of pathologic complete response (pathCR) in patients with esophageal carcinoma receiving preoperative chemoradiotherapy and to determine whether outcome after pathCR is related to clinical stage or treatment. METHODS. Clinical parameters and surgical specimens of patients with esophageal carcinoma undergoing preoperative chemoradiotherapy were analyzed to identify predictors of pathCR. In patients with pathCR, predictors of overall survival (OS), disease-free survival (DFS), and distant recurrence were studied. RESULTS. Sixty-nine (29{\%}) of 235 patients achieved pathCR. In patients with American Joint Committee on Cancer (AJCC) Stage II carcinoma, the proportion achieving pathCR was significantly larger than that achieving",
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AU - Wu, Tsung T.

AU - Liao, Zhongxing

AU - Komaki, Ritsuko

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AB - BACKGROUND. The purpose of the current study was to test the hypothesis that a lower clinical TNM stage is associated with a higher rate of pathologic complete response (pathCR) in patients with esophageal carcinoma receiving preoperative chemoradiotherapy and to determine whether outcome after pathCR is related to clinical stage or treatment. METHODS. Clinical parameters and surgical specimens of patients with esophageal carcinoma undergoing preoperative chemoradiotherapy were analyzed to identify predictors of pathCR. In patients with pathCR, predictors of overall survival (OS), disease-free survival (DFS), and distant recurrence were studied. RESULTS. Sixty-nine (29%) of 235 patients achieved pathCR. In patients with American Joint Committee on Cancer (AJCC) Stage II carcinoma, the proportion achieving pathCR was significantly larger than that achieving

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