Correlation of EUS measurement with pathologic assessment of neoadjuvant therapy response in esophageal carcinoma
Correlation of EUS measurement with pathologic assessment of neoadjuvant therapy response in esophageal carcinoma
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DOI：
10.1067/mge.2002.123273
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发表时间：
2002-05-01
影响因子：
7.7
通讯作者：
Chak, A
中科院分区：
文献类型：
--
作者：
Willis, J;Cooper, GS;Chak, A
背景资料：EUS测量的新辅助治疗后肿瘤大小的减小与食管癌患者的分期降低和生存率提高相关。本研究的目的是确定是否肿瘤的变化EUS测量对应于病理评估放化疗诱导的肿瘤region.Methods：41例食管癌患者接受综合治疗进行了研究。初次EUS后，患者完成顺铂/卡铂、5-氟尿嘧啶和放疗方案，并在切除前接受重复EUS。EUS阳性反应定义为最大肿瘤横截面积减少50%。放化疗诱导的肿瘤消退进行了评估，切除标本通过使用先前定义的病理评分系统的基础上肿瘤增殖到相邻fibrosis.Results的程度：病理肿瘤消退存在于23，不确定的5，和最小或缺席的13例。EUS在23例CRT诱导肿瘤消退的患者中测量到20例（87%）阳性反应，在13例无肿瘤消退的患者中测量到10例（77%）阴性反应（p < 0.001）。EUS对病理性肿瘤消退的阳性预测值为80%。结论：EUS测量肿瘤大小是术前评估病理性肿瘤消退的一种可靠的临床方法。
Background: EUS-measured reduction in tumor size after neoadjuvant therapy has previously been correlated with downstaging and improved survival in patients with esophageal cancer. The aim of this study was to determine whether tumor changes measured by EUS correspond to pathologically assessed chemoradiotherapy-induced tumor regression.Methods: Forty-one patients with esophageal cancer treated with combined modality treatment were studied. After initial EUS, patients completed a cisplatin/carboplatinum, 5-fluorouracil, and radiotherapy regimen and underwent repeat EUS before resection. A positive response on EUS was defined as a 50% reduction in maximal tumor cross-sectional area. Chemoradiotherapy-induced tumor regression was assessed in resection specimens by using a previously defined pathologic scoring system based on the extent of tumor proliferation into adjacent fibrosis.Results: Pathologic tumor regression was present in 23, indeterminate in 5, and minimal or absent in 13 patients. EUS measured a positive response in 20 of 23 (87%) patients with CRT-induced tumor regression and a negative response in 10 of 13 (77%) patients with absent tumor regression (p < 0.001). EUS had a positive predictive value of 80% for pathologic tumor regression.Conclusions: Measurement of tumor size by EUS is a reliable clinical method for assessing pathologic tumor regression before surgery.