What are the criteria for full response to neoadjuvant treatment for oesophagus cancer? surgery or follow-up?

Esophageal cancer is a progressive disease. Its survival rate is low compared to other tumors. The treatment strategy affects the survival of the patient. Treatment is controversial, especially in patients with complete response after neoadjuvant therapy. In our study, we investigated the criteria for complete response after neoadjuvant therapy and subsequent treatment processes.

Keywords:

Neoadjuvant treatment oesophagus cancer, surgery,

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Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71(3):209–249.
Huang FL, Yu SJ. Esophageal cancer: risk factors, genetic association, and treatment. Asian J Surg. 2018;41(3):210‐215.
Klingelhöfer D, Zhu Y, Braun M, Brüggmann D, Schöffel N, Groneberg DA. A world map of esophagus cancer research: a critical accounting. J Transl Med. 2019;17(1):150. 10.1186/s12967-019-1902-7.
Codipilly DC, Qin Y, Dawsey SM, et al. Screening for esophageal squamous cell carcinoma: recent advances. Gastrointest Endosc. 2018;88(3):413‐426.
Puet K,Bollschweiler E,Semrau R,et al.Neoadjuvant chemoradiation for patients with advanced oesophageal cancer – which response grading system best impacts prognostic discrimination? Histopathology April; 2019-:731-743.
A Hanna, R Birla, C Iosif, M Boeriu, R Tomsa, A Puscasu, S Constantinoiu Evaluation of Neoadjuvant Radiochemotherapy Response (RCT) in Squamous Esophageal Cancer (ESC) and Implications in Therapeutic Conduct Chirurgia (Bucur) May-Jun 2015;110(3):214-23.
Nagai Y,Yoshida N, Baba Y,et al.Clinical significance of evaluating endoscopic response to neoadjuvant chemotherapy in esophageal squamous cell carcinoma Digestive Endoscopy 2020 Jan;32(1):39-48.
Japan Esophageal Society. Esophagus. 2017; 14(1):37-65. Epub 2016 Nov 10.
G.S, A.S , M.S.Endoscopic and Imaging Predictors of Complete Pathologic Response After Chemoradiation for Esophageal Cancer Curr Gastroenterol Rep 2017 ;6;19(11):57.
Bates BA, Detterbeck FC, Bernard SA, Qaqish BF, Tepper JE. Concurrent radiation therapy and chemotherapy followed by esophagectomy for localized esophageal carcinoma. J Clin Oncol Off J Am Soc Clin Oncol. 1996;14(1):156–63.
Schneider PM, Metzger R, Schaefer H, Baumgarten F, Vallbohmer D, Brabender J, et al. Response evaluation by endoscopy, rebiopsy, and endoscopic ultrasound does not accurately predict histopathologic regression after neoadjuvant chemoradiation for esophageal cancer. Ann Surg. 2008;248(6):902–8
N D Cosgrove, D K Mullady Endoscopic evaluation of the esophageal cancer patient after chemoradiotherapy for persistent/recurrent cancer Diseases of the Esophagus.2018;31:7
F. Fujishima, Y. Taniyama, Y. Nakamura,et al.Residual carcinoma cells after chemoradiotherapy for esophageal squamous cell carcinoma patients: striving toward appropriate judgment of biopsy Diseases of the Esophagus .2018;1:6
B J Noordman , B P L Wijnhoven , S M Lagarde ,et al. Active surveillance in clinically complete responders after neoadjuvant chemoradiotherapy for esophageal or junctional cancer Dis Esophagus. 2017;1:30
van Rossum P S, Goense L, Meziani J et al. Endoscopic biopsy and EUS for the detection of pathologic complete response after neoadjuvant chemoradiotherapy in esophageal cancer: a systematic review and meta-analysis. Gastrointest Endosc 2016; 83: 866–79.
Misra S, Choi M, Livingstone A S et al. The role of endoscopic ultrasound in assessing tumor response and staging after neoadjuvant chemotherapy for esophageal cancer. Surg Endosc 2012; 26: 518–22.
Heinzow H S, Seifert H, Tsepetonidis S et al. Endoscopic ultrasound in staging esophageal cancer after neoadjuvant chemotherapy–results of a multicenter cohort analysis. J Gastrointest Surg 2013; 17: 1050–7.
Zuccaro G, Jr, Rice T W, Goldblum J et al. Endoscopic ultrasound cannot determine suitability for esophagectomy after aggressive chemoradiotherapy for esophageal cancer. Am J Gastroenterol 1999; 94: 906–12.
Sun F, Chen T, Han J et al. Staging accuracy of endoscopic ultrasound for esophageal cancer after neoadjuvant chemotherapy: a meta-analysis and systematic review. Dis Esophagus 2015; 28: 757–71.
B.M.Eyck, B.J. van der Wilk, S.M. Lagarde, B.P.L. Wijnhoven, R. Valkema et all. Neoadjuvant chemoradiotherapy for resectable oesophageal cancer Best Practice & Research Clinical Gastroenterology .2018;36-37:44.
van Rossum PS, van Lier AL, van Vulpen M, Reerink O, Lagendijk JJ, Lin SH, et al. Diffusion-weighted magnetic resonance imaging for the prediction of pathologic response to neoadjuvant chemoradiotherapy in esophageal cancer. Radiother Oncol. 2015;115(2): 163–70.
Djuric-Stefanovic A, Jankovic A, Saponjski D, et al. Analyzing the post-contrast attenuation of the esophageal wall on routine contrast-enhanced MDCT examination can improve the diagnostic accuracy in response evaluation of the squamous cell esophageal carcinoma to neoadjuvant chemoradiotherapy in comparison with the esophageal wall thickness.Abdom Radiol (NY).2019;44(5):1722-1733.
M.H. Li, D.P. Shang, C. Chen, L. Xu, Y. Huang, L. Kong, et al. Perfusion computed tomography in predicting treatment response of advanced squamous cell carcinomas, Asian Pac. J. Cancer Prev.2015;16:797-802.
Deng, W.Y.; Song, T.; Li, N.; Luo, S.X.; Li, X. Clinical observation and therapeutic evaluation of Rh-endostatin combined with DP regimen in treating patients with advanced esophageal cancer. Asian Pac. J. Cancer Prev.2014, 15, 6565–6570
A. Hanna, R. Birla, C. Iosif, et al. Evaluation of Neoadjuvant Radiochemotherapy Response (RCT) in Squamous Esophageal Cancer (ESC) and Implications in Therapeutic Conduct Chirurgia.2015 ;110: 214-223
Wieder HA, Brucher BL, Zimmermann F, Becker K, Lordick F, Beer A, et al. Time course of tumor metabolic activity during chemoradiotherapy of esophageal squamous cell carcinoma and response to treatment. J Am Soc Clin Oncol. 2004;22(5):900–8.
Molena D, Sun HH, Badr AS, Mungo B, Sarkaria IS, Adusumilli PS, et al. Clinical tools do not predict pathological complete response in patients with esophageal squamous cell cancer treated with definitive chemoradiotherapy. Dis Esophagus. 2014;27(4): 355–9.
N. Hammoudi a, C. Hennequina, L. Vercellino b, A. Costantini a, A. Valverdec, P. Cattand, L. Quéroa Early metabolic response to chemoradiotherapy by interim FDG PET/CT is associated with better overall survival and histological response in esophageal cancers Digestive and Liver Disease .2019;51 :887–893.
Valkema MJ, Noordman BJ; Bas P.L. Wijnhoven P.L,et al.Accuracy of 18F‐FDG PET/CT in predicting residual disease after neoadjuvant chemoradiotherapy for esophageal cancer Journal of Nuclear Medicine.2019;15:10.
de Gouw, D.J.J.M.; Klarenbeek, B.R.; Driessen, M.; Bouwense, S.A.W.; van Workum, F.; Fütterer, J.J.; Rovers, M.M.; ten Broek, R.P.G.; Rosman, C. Detecting Pathological Complete Response in Esophageal Cancer after Neoadjuvant Therapy Based on Imaging Techniques: A Diagnostic Systematic Review and Meta-Analysis. J. Thorac. Oncol. 2019, 14, 1156–1171.
Eyck, B.M.; van Lanschot, J.J.B.; Hulshof, M.C.C.M.; van der Wilk, B.J.; Shapiro, J.; van Hagen, P.; Henegouwen, M.I.V.B.; Wijnhoven, B.P.L.; van Laarhoven, H.W.M.; Nieuwenhuijzen, G.A.P.; et al. Ten-Year Outcome of Neoadjuvant Chemoradiotherapy Plus Surgery for Esophageal Cancer: The Randomized Controlled CROSS Trial. J. Clin. Oncol. 2021, 39, 1995–2004.
van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84.
Taketa T, Xiao L, Sudo K et al. Propensity-based matching between esophagogastric cancer patients who had surgery and who declined surgery after preoperative chemoradiation. Oncology 2013; 85: 95–9.
Castoro C, Scarpa M, Cagol M et al. Complete clinical response after neoadjuvant chemoradiotherapy for squamous cell cancer of the thoracic oesophagus: is surgery always necessary? J Gastrointest Surg 2013; 17: 1375–81.
Makoto Sohda, Tatsuya Mıyazakı, Makoto Sakaı, Yujı Kumakura, Hıroakı Honjyo, Keıgo Hara, Narıtaka Tanaka, Takehıko Yokoborı And Ken Shırabe Multidisciplinary Therapy for Locally Advanced Oesophageal Cancer With Special Reference To Surgical Conversion And Salvage ANTICANCER RESEARCH 39: 3167-3175 (2019)
Rizvi F.H, Syed A.A, Khattak S,et al. Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: A retrospective cohort study International Journal of Surgery.2014;12(6):621-625.
Di Corpo, M.; Schlottmann, F.; Strassle, P.D.; Nurczyk, K.; Patti, M.G. Treatment Modalities for Esophageal Adenocarcinoma in the United States: Trends and Survival Outcomes. J. Laparoendosc. Adv. Surg. Techniques Part A 2019, 29, 989–994.
Schlottmann F, Strassle PD, Gaber C, Patti MG. Stage III esophageal adenocarcinoma: Definitive chemoradiation vs. chemoradiation plus surgery. Updates Surg 2018;70: 423–426.
Sjoquist KM, Burmeister BH, Smithers BM, Zalcberg JR, Simes RJ, Barbour A, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: An updated meta-analysis. Lancet Oncol 2011;12:681–692.
Haefner MF, Lang K, Verma V, Koerber SA, Uhlmann L, Debus J, et al. Neoadjuvant versus definitive chemoradiotherapy for locally advanced esophageal cancer: Outcomes and patterns of failure. Strahlenther Onkol 2018;194:116–124.
Hamai Y, Hihara Y, Emi M,et al. Evaluation of Prognostic Factors for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery World J Surg.2018;42:1496-1505.
B.J, B.P.L, Lagarde S.M, et al. Organ-sparing treatment in oesophagus cancer: feasible and safe? Ned Tijdschr Geneeskd .2017;161: 1818.
Noordman B.J, Wijnhoven B.P.L, Lagarde S.M,et al. SANO-study group Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: a stepped-wedge cluster randomised trial BMC Cancer 2018 Feb 6;18(1):142.
clinicaltrials.gov. Centre Hospitalier Universitaire Dijon: Comparison of Systematic Surgery Versus Surveillance and Rescue Surgery in Operable Oesophageal Cancer With a Complete Clinical Response to Radiochemotherapy (Esostrate) NCT02551458 2015 [updated 1/12/16]. Available from: https://clinicaltrials.gov/ct2/show/NCT02 551458.