دورية أكاديمية
Locoregional Residual Esophageal Cancer after Neo-adjuvant Chemoradiotherapy and Surgery Regarding Anatomic Site and Radiation Target Fields A Histopathologic Evaluation Study:A Histopathologic Evaluation Study
| العنوان: | Locoregional Residual Esophageal Cancer after Neo-adjuvant Chemoradiotherapy and Surgery Regarding Anatomic Site and Radiation Target Fields A Histopathologic Evaluation Study:A Histopathologic Evaluation Study |
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| المؤلفون: | Faiz, Zohra, Kats-Ugurlu, Gursah, Mul, Véronique E M, Karrenbeld, Arend, Burgerhof, Hans G M, Plukker, John T M, Muijs, Christel T |
| المصدر: | Faiz , Z , Kats-Ugurlu , G , Mul , V E M , Karrenbeld , A , Burgerhof , H G M , Plukker , J T M & Muijs , C T 2022 , ' Locoregional Residual Esophageal Cancer after Neo-adjuvant Chemoradiotherapy and Surgery Regarding Anatomic Site and Radiation Target Fields A Histopathologic Evaluation Study : A Histopathologic Evaluation Study ' , Annals of Surgery , vol. 275 , no. 6 , pp. E759-E765 . https://doi.org/10.1097/SLA.0000000000004242Test |
| سنة النشر: | 2022 |
| المجموعة: | University of Groningen research database |
| مصطلحات موضوعية: | esophageal cancer, neoadjuvant CRT, site residual tumor, SQUAMOUS-CELL CARCINOMA, PATHOLOGICAL COMPLETE RESPONSE, PREOPERATIVE CHEMORADIOTHERAPY, TUMOR-REGRESSION, SURVIVAL, TOMOGRAPHY, MORTALITY, THERAPY, AGE |
| الوصف: | OBJECTIVE: Neoadjuvant chemoradiotherapy followed by surgery establishes a considerable pathologic complete response (pCR) in EC. The aim was to determine site of residual tumor and its prognostic impact. SUMMARY BACKGROUND DATA: High rates of residual tumor in the adventitial region even inside the radiation fields will influence current decision-making. METHODS: We evaluated resection specimens with marked target fields from 151 consecutive EC patients treated with carboplatin/paclitaxel and 41.4Gy between 2009 and 2018. RESULTS: In radically resected (R0) specimens 19.8% (27/136) had a pCR (ypT0N0) and 14% nearly no response (tumor regression grade: tumor regression grade 4-5). Residual tumor commonly extended in or restricted to the adventitia (43.1%; 47/109), whereas 7.3% was in the mucosa (ypT1a), 16.5% in the submucosa (ypT1b) and 6.4% only in lymph nodes (ypT0N+). Macroscopic residues in R0-specimens of partial responders (tumor regression grade 2-3: N = 90) were found in- and outside the gross tumor volume (GTV) in 33.3% and 8.9%, and only microscopic in- and outside the clinical target volume in 58.9% and 1.1%, respectively. Residual nodal disease was observed proximally and distally to the clinical target volume in 2 and 5 patients, respectively. Disease Free Survival decreased significantly if macroscopic tumor was outside the GTV and in ypT2-4aN+. CONCLUSIONS: After neoadjuvant chemoradiotherapy, pCR and ypT1aN0 were seen in a limited number of R0 resected specimens (19.8% and 7.3%, respectively), whereas 6.4% had only nodal disease (yT0N+). Disease Free Survival decreased significantly if macroscopic residue was outside the GTV and in responders with only nodal disease. Therefore, we should be cautious in applying wait and see strategies. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://research.rug.nl/en/publications/d005b135-5c40-42df-aa29-797c8f0d260aTest |
| DOI: | 10.1097/SLA.0000000000004242 |
| الإتاحة: | https://doi.org/10.1097/SLA.0000000000004242Test https://hdl.handle.net/11370/d005b135-5c40-42df-aa29-797c8f0d260aTest https://research.rug.nl/en/publications/d005b135-5c40-42df-aa29-797c8f0d260aTest https://pure.rug.nl/ws/files/131461072/Locoregional_Residual_Esophageal_Cancer_after.94308.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.6002AC47 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/SLA.0000000000004242 |
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