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Titolo:
Endosonographic assessment of multimodality therapy predicts survival of esophageal carcinoma patients
Autore:
Chak, A; Canto, MI; Cooper, GS; Isenberg, G; Willis, J; Levitan, N; Clayman, J; Forastiere, A; Heath, E; Sivak, MV;
Indirizzi:
Univ Hosp Cleveland, Div Gastroenterol, Cleveland, OH 44106 USA Univ Hosp Cleveland Cleveland OH USA 44106 terol, Cleveland, OH 44106 USA Johns Hopkins Hosp, Baltimore, MD 21287 USA Johns Hopkins Hosp Baltimore MD USA 21287 s Hosp, Baltimore, MD 21287 USA
Titolo Testata:
CANCER
fascicolo: 8, volume: 88, anno: 2000,
pagine: 1788 - 1795
SICI:
0008-543X(20000415)88:8<1788:EAOMTP>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
SQUAMOUS-CELL CARCINOMA; RADIATION-THERAPY; NEOADJUVANT THERAPY; GASTROESOPHAGEAL JUNCTION; PREOPERATIVE CHEMOTHERAPY; ENDOSCOPIC ULTRASONOGRAPHY; INDUCTION CHEMOTHERAPY; ADENOCARCINOMA; CANCER; RESECTION;
Keywords:
endosonography; esophagus; multimodality therapy; survival;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Chak, A Univ Hosp Cleveland, Div Gastroenterol, 11100 Euclid Ave, Cleveland, OH 44106 USA Univ Hosp Cleveland 11100 Euclid Ave Cleveland OH USA 4410606 USA
Citazione:
A. Chak et al., "Endosonographic assessment of multimodality therapy predicts survival of esophageal carcinoma patients", CANCER, 88(8), 2000, pp. 1788-1795

Abstract

BACKGROUND. Standard endosonographic (EUS) staging criteria are unreliablefor staging esophageal carcinoma after neoadjuvant therapy; however, measurement of tumor size reduction can identify patients who have achieved a pathologic response. In the current study the authors prospectively compared survival between patients classified as responders and those classified as nonresponders by EUS. METHODS, The maximal transverse cross-sectional area of the tumor was measured before and after neoadjuvant therapy in patients who were candidates for multimodality treatment. Response was defined as a greater than or equalto 50% reduction in tumor area. RESULTS. A total of 59 patients at 2 centers were followed for a median of19 months. EUS assessed response in 34 patients (58%). Overall, respondershad a median survival of 17.6 months compared with 14.5 months for nonresponders (P < 0.005). Survival was significantly longer in responders compared with nonresponders in the patient subgroup who underwent surgical resection (19.7 months vs. 14.6 months; P < 0.005), the patient subgroup with adenocarcinoma (21.4 months vs. 10.8 months; P < 0.005), and the patient subgroup initially classified as having T3N1 disease (17.6 months vs. 14.1 months; P < 0.05). Survival was not found to differ significantly between responders and nonresponders in the subgroup of patients with squamous cell carcinoma. EUS response nas the only clinical variable that was associated with survival time in a multivariate analysis (relative hazard = 0.27; P < 0.005). CONCLUSIONS, Patients with esophageal carcinoma who respond to neoadjuvanttreatment as identified by EUS measurement of reduction in tumor size havea significantly better prognosis than nonresponders. Cancer 2000;88:1788-95. (C) 2000 American Cancer Society.

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Documento generato il 01/12/20 alle ore 09:54:56