Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations.
Anne-Marie Mandard,Frédéric Dalibard,Jean-Claude Mandard,Jacques Marnay,Michel Henry-Amar,Jean-François Petiot,Alain Roussel,Jacques-Henry Jacob,Philippe Segol,Guy Samama,Jean-Marie Ollivier,Sylvie Bonvalot,M. Gignoux +12 more
Reads0
Chats0
TLDR
A pilot study was undertaken to determine if pathologic assessment of tumor regression correlated with disease free survival in patients with esophageal carcinoma.Abstract:
Background. The benefits of preoperative chemotherapy and radiation for esophageal carcinoma are under investigation. A pilot study was undertaken to determine if pathologic assessment of tumor regression correlated with disease free survival.
Methods. Ninety-three resected specimens from patients treated with cis-dichloro-diamino cisplatin and irradiation before surgery were examined on semiserial sections. Patients selected for surgery were all Status 1 according to the World Health Organization (WHO) classification. Histologic typing was based on the WHO classification. Tumor regression grade (TRG) was quantitated in five grades: TRG 1 (complete regression) showed absence of residual cancer and fibrosis extending through the different layers of the esophageal wall; TRG 2 was characterized by the presence of rare residual cancer cells scattered through the fibrosis; TRG 3 was characterized by an increase in the number of residual cancer cells, but fibrosis still predominated; TRG 4 showed residual cancer outgrowing fibrosis; and TRG 5 was characterized by absence of regressive changes.
Survival curves were estimated according to the Kaplan-Meier method. A quantification of the relationship between treatment failure and confounding variables (age, tumor location, tumor size, esophageal wall involvement by residual cancer and/or regressive changes, histology, treatment, adequacy of surgery, pathologic lymph node status, and tumor regression grade) was done using Cox's proportional hazards model.
Results. Forty-two percent of specimens were TGR 1–2; 20%, TGR 3; and 33%, TGR 4–5. Univariate analysis found that tumor size, pathologic lymph node status, tumor regression grade, and esophageal wall involvement were highly correlated with disease free survival (P > 0.05). After multivariate analysis, only tumor regression (i.e., TRG 1–3 versus TRG 4–5) remained a significant (P > 0.001) predictor of disease free survival.
Conclusions. This study highlights the importance of tumor regression in the survival of patients with esophageal carcinoma treated with preoperative chemoradiotherapy. These findings suggest that tumor regression grade should be considered when evaluating therapeutic results. Cancer 1994; 73:2680–6.read more
Citations
More filters
Journal ArticleDOI
Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer
TL;DR: Preoperative chemoradiotherapy improved survival among patients with potentially curable esophageal or esophagogastric-junction cancer and the regimen was associated with acceptable adverse-event rates.
Journal ArticleDOI
Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
TL;DR: This book aims to provide a history of Radiotherapy and Oncology in Europe and investigates the role of radiotherapy in the development of central nervous system disorders.
Journal ArticleDOI
Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial.
Surya S. A. Y. Biere,Mark I. van Berge Henegouwen,K. W. Maas,Luigi Bonavina,Camiel Rosman,Josep Garcia,Suzanne S. Gisbertz,Jean H. G. Klinkenbijl,Markus W. Hollmann,Elly S. M. de Lange,H. Jaap Bonjer,Donald L. van der Peet,Miguel A. Cuesta +12 more
TL;DR: Findings provide evidence for the short-term benefits of minimally invasive oesophagectomy for patients with resectable Oesophageal cancer.
Journal ArticleDOI
Chemoradiotherapy Followed by Surgery Compared with Surgery Alone in Squamous-Cell Cancer of the Esophagus
Jean-François Bosset,Gignoux M,Triboulet Jp,E Tiret,G Mantion,Dominique Elias,P Lozach,Ollier Jc,J J Pavy,M Mercier,T Sahmoud +10 more
TL;DR: A multicenter, randomized trial to compare preoperative chemoradiotherapy followed by surgery with surgery alone in patients with stage I and II squamous-cell cancer of the esophagus with patients assigned to combined therapy.
Journal ArticleDOI
Pathological features of rectal cancer after preoperative radiochemotherapy
TL;DR: It is thought that preoperative radiochemotherapy is able to reduce tumor mass thus achieving operability in non-curatively operable cases and recommend standards of pathological work up and regression grading for further studies comparing surgery and radiochemistry of rectal carcinoma.
References
More filters
Book ChapterDOI
Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
BookDOI
TNM classification of malignant tumours
TL;DR: Head and Neck Tumours.- Lip and Oral Cavity.- Pharynx.- Larynx.' Maxillary Sinus.- Salivary Glands.- Thyroid Gland.- Digestive System Tumour .
Book
Cancer : Principles and Practice of Oncology
TL;DR: Part I: Molecular Biology of Cancer Molecular Methods in Oncology Section 1. Amplification Techniques Section 2. RNA Interference Section 3. cDNA arrays Section 4. Tissue arrays Section 5. Cytogenetics Section 6. Bioinformatics Genomics and Proteomics Molecular Targets in oncology.
Journal ArticleDOI
Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples.
Richard Peto,M.C. Pike,P. Armitage,N. E. Breslow,David Cox,S V Howard,N Mantel,Klim McPherson,Julian Peto,Pete Smith +9 more
TL;DR: Efficient methods of analysis of randomized clinical trials in which the authors wish to compare the duration of survival among different groups of patients are described.
Journal ArticleDOI
Cancer: Principles and Practice of Oncology
TL;DR: The third edition of DeVita, Hellman, and Rosenberg's by now classic text on cancer preserves the multimodal, integrated approach to clinical evaluation and treatment of that disease.
Related Papers (5)
Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data
Monique Maas,Patty J. Nelemans,Vincenzo Valentini,Prajnan Das,Claus Rödel,Li Jen Kuo,Felipe A. Calvo,Julio Garcia-Aguilar,Rob Glynne-Jones,Karin Haustermans,Mohammed Mohiuddin,Salvatore Pucciarelli,William Small,Javier Suárez,George Theodoropoulos,Sebastiano Biondo,Sebastiano Biondo,Regina G. H. Beets-Tan,Geerard L. Beets +18 more