Which is the Optimal Response Criteria for Evaluating Preoperative Treatment in Esophageal Cancer: RECIST or Histology?
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Preoperative treatment is a promising strategy for improving long-term outcomes in advanced esophageal cancer. Two tumor response evaluation criteria for preoperative treatment are available: response evaluation criteria in solid tumors (RECIST) and histological criteria. This prospective study aimed to identify which was a better surrogate end point for survival in the preoperative setting.
We analyzed all eligible patients (n = 164) from the preoperative treatment group in a phase III trial comparing preoperative versus postoperative 5-fluorouracil plus cisplatin for clinical stage II or III esophageal cancer. Intercriteria reliability was evaluated with the proportion of agreement and the kappa coefficient. For validity analyses, hazard ratios (HR) of response to nonresponse and differences in response rates between short- and long-term survivors were evaluated.
The clinical and histological response rates were 37.8 % (62 of 164) and 20.1 % (33 of 164), respectively. The proportion of agreement for response to nonresponse between the 2 criteria was 70.3 %, and the kappa coefficient was 0.34. The HR for death in patients with histological response (0.22, 95 % confidence interval 0.09–0.55, P < 0.001) was lower than for those with RECIST response (0.55, 95 % confidence interval 0.33–0.91, P = 0.018). The difference in response rates between short- and long-term survivors according to histological criteria (27 vs. 7 %, P < 0.001) was larger than with RECIST (42 vs. 30 %, P = 0.13).
Intercriteria agreement was relatively low, and histological criteria yielded more valid assessments of response than RECIST. Histological response rate seemed to be the better surrogate end point of survival in the preoperative setting.
- GLOBOCAN 2008. http://globocan.iarc.fr/.
- Medical Research Council Oesophageal Cancer Working Group. GICAL resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet. 2002;359:1727–33. CrossRef
- Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol. 2009;27:5062–7. CrossRef
- Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74. CrossRef
- Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16. CrossRef
- Sobin LH, Wittekind C. TNM classification of malignant tumors. 6th ed. New York: Wiley-Liss; 2002. p. 60–5.
- Hirao M, Ando N, Tsujinaka T, et al. Influence of preoperative chemotherapy for advanced thoracic oesophageal squamous cell carcinoma on perioperative complications. Br J Surg. 2011;98:1735–41. CrossRef
- Japanese Society for Esophageal Diseases. Guideline for clinical and pathological studies on carcinoma of the esophagus, ninth edition: part II. Esophagus. 2004;1:107–25.
- Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47. CrossRef
- Brücher BL, Weber W, Bauer M, et al. Neoadjuvant therapy of esophageal squamous cell carcinoma: response evaluation by positron emission tomography. Ann Surg. 2001;233:300–9. CrossRef
- Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging. J Clin Oncol. 2001;19:3058–65.
- Flamen P, Van Cutsem E, Lerut A, et al. Positron emission tomography for assessment of the response to induction radiochemotherapy in locally advanced oesophageal cancer. Ann Oncol. 2002;13:361–8. CrossRef
- van Heijl M, Omloo JM, van Berge Henegouwen MI, et al. Fluorodeoxyglucose positron emission tomography for evaluating early response during neoadjuvant chemoradiotherapy in patients with potentially curable esophageal cancer. Ann Surg. 2011;253:56–63. CrossRef
- Becker K, Fumagalli U, Mueller JD, et al. Preoperative chemotherapy for patients with locally advanced esophageal carcinoma: effect on tumor cell microinvolvement of regional lymph nodes. Cancer. 1999;85:1484–9. CrossRef
- Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in esophageal carcinoma treated with preoperative chemotherapy. Cancer. 2003;98:1521–30. CrossRef
- Ajani JA, Mansfield PF, Janjan N, et al. Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable esophageal carcinoma. J Clin Oncol. 2004;22:2774–80. CrossRef
- Ajani JA, Mansfield PF, Crane CH, et al. Paclitaxel-based chemoradiotherapy in localized esophageal carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome. J Clin Oncol. 2005;23:1237–44. CrossRef
- Bosset JF, Gignoux M, Triboulet JP, et al. Chemoradiotherapy followed by surgery compared with surgery alone in squamous-cell cancer of the esophagus. N Engl J Med. 1997;337:161–7. CrossRef
- Tepper J, Krasna MJ, Niedzwiecki D, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26:1086–92. CrossRef
- van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–84. CrossRef
- Which is the Optimal Response Criteria for Evaluating Preoperative Treatment in Esophageal Cancer: RECIST or Histology?
Annals of Surgical Oncology
Volume 20, Issue 9 , pp 3009-3014
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- 1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
- 2. Japan Clinical Oncology Group Data Center, National Cancer Center, Tokyo, Japan
- 3. Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
- 4. Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
- 5. Department of Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan