Residual Cancer Volume Predicts Clinical Outcome in Patients With Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemotherapy
Residual Cancer Volume Predicts Clinical Outcome in Patients With Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemotherapy
复制标题
残留癌体积可预测食管鳞状细胞癌新辅助化疗后的临床结果
DOI：
10.1177/1066896919855760
复制
发表时间：
2019
影响因子：
1.2
通讯作者：
A. Yanagisawa
中科院分区：
文献类型：
--
作者：
Ryuta Nakao;E. Konishi;H. Fujiwara;E. Otsuji;I. Yokota;Y. Urata;A. Yanagisawa
背景资料。本研究的目的是评估食管鳞癌(ESCC)患者在新辅助化疗后接受食道切除术后残癌体积(RCV)的预后意义。方法：研究方法。对81例临床分期为IB~III期的ESCC患者，每隔6~8 mm用完整的阶梯式切片测量RCV。RCV定义为残癌面积和厚度的乘积的总和，通过对3年疾病特异性生存(DSS)的受试者特征曲线分析来确定其临界值。多变量分析与组织病理学因素进行比较，包括根据日本食道癌分类(TRG-JPN)或Becker等人(TRG-Becker)报道的肿瘤消退级别。结果。RCV范围为0~49.3 cm~3(中位数为1.4 cm~3)，临界值为1.0 cm~3(敏感度为78%，特异度为68%)。在Kaplan-Meier曲线分析和对数等级检验中，RCV>；1.0cm3预测无复发生存率(RFS；5年RFS率，12%比47%；P<；.001)和DSS(5年DSS率，27%比61%；P<；.001)的预后较差。COX风险模型的多因素分析显示，与包括TRG-Becker的组织病理学因素相比，RCV>；1.0cm3是预测RFS(P=.013；风险比[HR]=2.62)和DSS(P=.028；HR=2.56)预后不良的因素。结论。提示测定RCV是预测ESCC患者新辅助化疗后预后的一种新方法。
Background. The aim of this study was to assess the prognostic significance of residual cancer volume (RCV) in patients with esophageal squamous cell carcinoma (ESCC) who received esophagectomy after neoadjuvant chemotherapy. Methods. We measured RCV by using complete stepwise sections at 6- to 8-mm intervals obtained from 81 ESCC patients with clinical stages IB to III. RCV was defined as the summation of all products of residual cancer area and thickness, and its cutoff value was set by receiver operator characteristic curve analysis on 3-year disease-specific survival (DSS). The multivariate analyses were performed in comparison with histopathological factors including tumor regression grades according to the Japanese Classification of Esophageal Cancer (TRG-JPN) or reported by Becker et al (TRG-Becker). Results. The range of RCV was 0 to 49.3 cm3 (median = 1.4 cm3), and the cutoff value was set at 1.0 cm3 (sensitivity = 78%; specificity = 68%). In the Kaplan-Meier curve analysis with the log-rank test, RCV > 1.0 cm3 predicted poorer prognosis for relapse-free survival (RFS; 5-year RFS rate, 12% vs 47%; P < .001) and DSS (5-year DSS rate, 27% vs 61%; P < .001). The multivariate analyses by the Cox hazards model revealed that RCV > 1.0 cm3 was a factor predicting poor prognosis for RFS (P = .013; hazard ratios [HR] = 2.62) and DSS (P = .028; HR = 2.56) compared with histopathological factors including TRG-JPN; RFS (P = .014; HR = 3.03) and DSS (P = .045; HR = 2.71) compared with histopathological factors including TRG-Becker. Conclusions. The study suggested that determining RCV is a new method of predicting prognosis in ESCC patients after neoadjuvant chemotherapy.
日本食管癌的分类，第11版：第一部分。
DOI：
10.1007/s10388-016-0551-7
发表时间：
2017
期刊：
Esophagus : official journal of the Japan Esophageal Society
影响因子：
--
作者：
Japan Esophageal Society
通讯作者：
Japan Esophageal Society