Failure patterns correlate with the proportion of residual carcinoma after preoperatlve chemoradiotherapy for carcinoma of the esophagus

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

Research output: Contribution to journalArticle

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Abstract

BACKGROUND. The current study was conducted to test the hypothesis that patterns of failure are correlated with the degree of residual carcinoma after preoperative chemoradiotherapy (CRT) in patients with esophageal carcinoma. METHODS. The authors analyzed the clinical characteristics of patients with carcinoma of the esophagus who underwent preoperative CRT. The residual carcinoma in the resected specimen was categorized into 3 groups (0%, 1-50%, and > 50%). The initial patterns of failure were analyzed according to these categories. RESULTS. Of the 235 patients who underwent CRT, 69 (29%) achieved a pathologic complete response (pathCR; Group A), 109 patients (46%) achieved a response but it was less than a pathCR (1-50% residual carcinoma; Group B), and 57 (24%) had no response (> 50% residual carcinoma; Group C). The time to locoregional recurrence was significantly longer for Group A compared with Group C (P = 0.05). The rate of distant metastases was significantly lower in Groups A and B compared with Group C (14% in Group A, 29% in Group B, and 33% in Group C; P = 0.03). The distant metastases-free survival was found to be significantly longer in Groups A and B compared with Group C (Group A vs. Group B, P = 0.01; Group A vs. Group C, P < 0.0001; and Group B vs. Group C, P = 0.03). A significantly higher proportion of patients in the responding groups (Groups A and B) had no disease recurrence compared with Group C (81% in Group A, 67% in Group B, and 61% in Group C; P = 0.04). The overall survival and disease-free survival were found to be significantly longer in Groups A and B compared with Group C. CONCLUSIONS. Data from the current study demonstrate that the proportion of residual carcinoma after preoperative CRT is significantly correlated with patterns of locoregional and distant failure. Future investigations should focus on reducing the proportion of residual carcinoma and metastatic disease progression in patients with esophageal carcinoma.

Original languageEnglish (US)
Pages (from-to)1349-1355
Number of pages7
JournalCancer
Volume104
Issue number7
DOIs
StatePublished - Oct 1 2005
Externally publishedYes

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Chemoradiotherapy
Esophagus
Carcinoma
Neoplasm Metastasis
Recurrence
Survival
Disease-Free Survival
Disease Progression

Keywords

  • Correlation
  • Esophageal carcinoma
  • Failure patterns
  • Preoperative chemoradiotherapy
  • Residual carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Rohatgi, P. R., Swisher, S. G., Correa, A. M., Wu, T. T., Liao, Z., Komaki, R., ... Ajani, J. A. (2005). Failure patterns correlate with the proportion of residual carcinoma after preoperatlve chemoradiotherapy for carcinoma of the esophagus. Cancer, 104(7), 1349-1355. https://doi.org/10.1002/cncr.21346

Failure patterns correlate with the proportion of residual carcinoma after preoperatlve chemoradiotherapy for carcinoma of the esophagus. / Rohatgi, Pooja R.; Swisher, Stephen G.; Correa, Arlene M.; Wu, Tsung T.; Liao, Zhongxing; Komaki, Ritsuko; Walsh, Garrett; Vaporciyan, Ara; Lynch, Patrick M.; Rice, David C.; Roth, Jack A.; Ajani, Jaffer A.

In: Cancer, Vol. 104, No. 7, 01.10.2005, p. 1349-1355.

Research output: Contribution to journalArticle

Rohatgi, PR, Swisher, SG, Correa, AM, Wu, TT, Liao, Z, Komaki, R, Walsh, G, Vaporciyan, A, Lynch, PM, Rice, DC, Roth, JA & Ajani, JA 2005, 'Failure patterns correlate with the proportion of residual carcinoma after preoperatlve chemoradiotherapy for carcinoma of the esophagus', Cancer, vol. 104, no. 7, pp. 1349-1355. https://doi.org/10.1002/cncr.21346
Rohatgi, Pooja R. ; Swisher, Stephen G. ; Correa, Arlene M. ; Wu, Tsung T. ; Liao, Zhongxing ; Komaki, Ritsuko ; Walsh, Garrett ; Vaporciyan, Ara ; Lynch, Patrick M. ; Rice, David C. ; Roth, Jack A. ; Ajani, Jaffer A. / Failure patterns correlate with the proportion of residual carcinoma after preoperatlve chemoradiotherapy for carcinoma of the esophagus. In: Cancer. 2005 ; Vol. 104, No. 7. pp. 1349-1355.
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abstract = "BACKGROUND. The current study was conducted to test the hypothesis that patterns of failure are correlated with the degree of residual carcinoma after preoperative chemoradiotherapy (CRT) in patients with esophageal carcinoma. METHODS. The authors analyzed the clinical characteristics of patients with carcinoma of the esophagus who underwent preoperative CRT. The residual carcinoma in the resected specimen was categorized into 3 groups (0{\%}, 1-50{\%}, and > 50{\%}). The initial patterns of failure were analyzed according to these categories. RESULTS. Of the 235 patients who underwent CRT, 69 (29{\%}) achieved a pathologic complete response (pathCR; Group A), 109 patients (46{\%}) achieved a response but it was less than a pathCR (1-50{\%} residual carcinoma; Group B), and 57 (24{\%}) had no response (> 50{\%} residual carcinoma; Group C). The time to locoregional recurrence was significantly longer for Group A compared with Group C (P = 0.05). The rate of distant metastases was significantly lower in Groups A and B compared with Group C (14{\%} in Group A, 29{\%} in Group B, and 33{\%} in Group C; P = 0.03). The distant metastases-free survival was found to be significantly longer in Groups A and B compared with Group C (Group A vs. Group B, P = 0.01; Group A vs. Group C, P < 0.0001; and Group B vs. Group C, P = 0.03). A significantly higher proportion of patients in the responding groups (Groups A and B) had no disease recurrence compared with Group C (81{\%} in Group A, 67{\%} in Group B, and 61{\%} in Group C; P = 0.04). The overall survival and disease-free survival were found to be significantly longer in Groups A and B compared with Group C. CONCLUSIONS. Data from the current study demonstrate that the proportion of residual carcinoma after preoperative CRT is significantly correlated with patterns of locoregional and distant failure. Future investigations should focus on reducing the proportion of residual carcinoma and metastatic disease progression in patients with esophageal carcinoma.",
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author = "Rohatgi, {Pooja R.} and Swisher, {Stephen G.} and Correa, {Arlene M.} and Wu, {Tsung T.} and Zhongxing Liao and Ritsuko Komaki and Garrett Walsh and Ara Vaporciyan and Lynch, {Patrick M.} and Rice, {David C.} and Roth, {Jack A.} and Ajani, {Jaffer A.}",
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T1 - Failure patterns correlate with the proportion of residual carcinoma after preoperatlve chemoradiotherapy for carcinoma of the esophagus

AU - Rohatgi, Pooja R.

AU - Swisher, Stephen G.

AU - Correa, Arlene M.

AU - Wu, Tsung T.

AU - Liao, Zhongxing

AU - Komaki, Ritsuko

AU - Walsh, Garrett

AU - Vaporciyan, Ara

AU - Lynch, Patrick M.

AU - Rice, David C.

AU - Roth, Jack A.

AU - Ajani, Jaffer A.

PY - 2005/10/1

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N2 - BACKGROUND. The current study was conducted to test the hypothesis that patterns of failure are correlated with the degree of residual carcinoma after preoperative chemoradiotherapy (CRT) in patients with esophageal carcinoma. METHODS. The authors analyzed the clinical characteristics of patients with carcinoma of the esophagus who underwent preoperative CRT. The residual carcinoma in the resected specimen was categorized into 3 groups (0%, 1-50%, and > 50%). The initial patterns of failure were analyzed according to these categories. RESULTS. Of the 235 patients who underwent CRT, 69 (29%) achieved a pathologic complete response (pathCR; Group A), 109 patients (46%) achieved a response but it was less than a pathCR (1-50% residual carcinoma; Group B), and 57 (24%) had no response (> 50% residual carcinoma; Group C). The time to locoregional recurrence was significantly longer for Group A compared with Group C (P = 0.05). The rate of distant metastases was significantly lower in Groups A and B compared with Group C (14% in Group A, 29% in Group B, and 33% in Group C; P = 0.03). The distant metastases-free survival was found to be significantly longer in Groups A and B compared with Group C (Group A vs. Group B, P = 0.01; Group A vs. Group C, P < 0.0001; and Group B vs. Group C, P = 0.03). A significantly higher proportion of patients in the responding groups (Groups A and B) had no disease recurrence compared with Group C (81% in Group A, 67% in Group B, and 61% in Group C; P = 0.04). The overall survival and disease-free survival were found to be significantly longer in Groups A and B compared with Group C. CONCLUSIONS. Data from the current study demonstrate that the proportion of residual carcinoma after preoperative CRT is significantly correlated with patterns of locoregional and distant failure. Future investigations should focus on reducing the proportion of residual carcinoma and metastatic disease progression in patients with esophageal carcinoma.

AB - BACKGROUND. The current study was conducted to test the hypothesis that patterns of failure are correlated with the degree of residual carcinoma after preoperative chemoradiotherapy (CRT) in patients with esophageal carcinoma. METHODS. The authors analyzed the clinical characteristics of patients with carcinoma of the esophagus who underwent preoperative CRT. The residual carcinoma in the resected specimen was categorized into 3 groups (0%, 1-50%, and > 50%). The initial patterns of failure were analyzed according to these categories. RESULTS. Of the 235 patients who underwent CRT, 69 (29%) achieved a pathologic complete response (pathCR; Group A), 109 patients (46%) achieved a response but it was less than a pathCR (1-50% residual carcinoma; Group B), and 57 (24%) had no response (> 50% residual carcinoma; Group C). The time to locoregional recurrence was significantly longer for Group A compared with Group C (P = 0.05). The rate of distant metastases was significantly lower in Groups A and B compared with Group C (14% in Group A, 29% in Group B, and 33% in Group C; P = 0.03). The distant metastases-free survival was found to be significantly longer in Groups A and B compared with Group C (Group A vs. Group B, P = 0.01; Group A vs. Group C, P < 0.0001; and Group B vs. Group C, P = 0.03). A significantly higher proportion of patients in the responding groups (Groups A and B) had no disease recurrence compared with Group C (81% in Group A, 67% in Group B, and 61% in Group C; P = 0.04). The overall survival and disease-free survival were found to be significantly longer in Groups A and B compared with Group C. CONCLUSIONS. Data from the current study demonstrate that the proportion of residual carcinoma after preoperative CRT is significantly correlated with patterns of locoregional and distant failure. Future investigations should focus on reducing the proportion of residual carcinoma and metastatic disease progression in patients with esophageal carcinoma.

KW - Correlation

KW - Esophageal carcinoma

KW - Failure patterns

KW - Preoperative chemoradiotherapy

KW - Residual carcinoma

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