The role of the pathologic response to nRCT might be one clinically significant component in this puzzle. There are, still, biological factors influencing survival outcome that are in urgent need to be studied and understood.
PATHOLOGICAL COMPLETE RESPONSE TRIAL
The Dutch controlled randomized trial CROSS has showed a clear survival benefit of nRCT and, consecutively, the regimen, encompassing of de-escalated radiotherapy dose (41.4 Gy) and a well tolerable chemotherapy combination (carboplatin, paclitaxel) has become a new treatment option for the patients with locally advanced esophageal cancer in many institutes around the world ( 5, 6). Several meta-analyses have found an OS benefit of the application of nRCT prior to surgery compared surgery alone ( 2- 4). The trimodal strategy, encompassing surgery, radiotherapy and chemotherapy, and its clinical meaning has been widely studied and has become a standard of care ( 1). The addition of nRCT to the surgery might be associated with improvement of overall survival (OS) and disease-free survival (DFS) in this group. Neoadjuvant radiochemotherapy (nRCT) has been the standard of care in the context of a curative treatment strategy of non-metastatic but locally advanced esophageal cancer. Keywords: Pathological complete response (pCR) neoadjuvant treatment neoadjuvant radiochemotherapy (nRCT) esophageal cancer The median time of local recurrence was 3.8☐.4 years in pCR group and 1.8☐.2 years in non-pCR group (P=0.01), while the median time of distant metastases in pCR group was 1.2☐.5 years and 1.1☐.2 years in non-pCR group (P=0.6).Ĭonclusions: Complete pathological response predicts significantly higher rates of OS and DFS in patients with locally advanced esophageal cancer treated with nRCT followed by surgery. The patients who achieved pCR had significantly higher 5-year OS and 5-year DFS rates: 47.2% and 48% compared to 27.3% and 21% for the non-pCR patients respectively (P=0.04, 0.03). The median overall survival (OS) of the entire group was 3.5☑.2 years, and the 5-year OS rate was 38.2%, while the median disease-free survival (DFS) was 2.1☐.4 years and the 5-year DFS rate was 33.1%. The total radiation dose was 45 Gy in 76.8% of the patients and 50.4 Gy in 23.2%. Histological types included squamous cell carcinoma (75%) and adenocarcinoma (25%). The average age was 62 years (☙.1), and most patients were males (83.9%). Results: Fifty-six patients with invasive cancer, 23 patients (41.1%) achieved pCR and 33 patients had non-pCR (58.9%) following nRCT. The patients were categorized into two groups according to the pathological response following nRCT: pCR group and non-pCR group.
Methods: All patients treated with nRCT followed by surgery between January 2005 and December 2015 were reviewed. This work represents a single-center analysis investigating the impact of pathological complete response (pCR) on treatment outcome. The pathological response is an important predictor in such patients. Interviews with Outstanding Guest Editorsīackground: Neoadjuvant radiochemotherapy (nRCT) followed by surgery has become the gold standard treatment in patients with locally advanced esophageal cancer.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process.
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