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Novel Criterion Using Esophageal Major and Minor Axes is Useful to Evaluate the Therapeutic Effect and Prognosis After Neoadjuvant Chemotherapy Followed by Surgery in Locally Advanced Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

An appropriate strategy is needed to determine the therapeutic effect of chemotherapy on primary lesions in esophageal cancer. This multicenter cohort study aimed to examine the usefulness of a novel criterion obtained by multiplying the lengths of the major and minor esophageal axes from helical computed tomography as a tool to evaluate the therapeutic effect of neoadjuvant chemotherapy and to predict prognosis after surgery in locally advanced esophageal cancer.

Materials and Methods

A first investigation evaluated the reproducibility of the new criterion between two independent examiners. In a second investigation, we examined the association of the novel criterion with pathological tumor regression grade and long-term outcomes. Pretreatment primary lesions less than 20 mm on computed tomography were excluded.

Results

In an initial cohort of 81 patients, the intraclass correlation coefficient for the novel criterion was higher than that for the tumor major axis both before and after neoadjuvant chemotherapy. In the second cohort of 255 patients, the novel criterion significantly correlated with tumor regression grade (p = 0.0003), overall survival (p < 0.0001), and disease-free survival (p < 0.0001). It was also an independent predictor for overall survival (p = 0.0023), along with age, tumor regression grade, and pathological stage.

Conclusions

The measurement derived by multiplying the esophageal major and minor axes on computed tomography is easy to obtain and has better objectivity and reproducibility for tumors of any shape. This novel criterion may be clinically useful because it can estimate therapeutic effect, tumor regression grade, and prognosis after neoadjuvant chemotherapy followed by surgery for esophageal cancer.

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Acknowledgement

The authors sincerely appreciate Yuichiro Doki, MD, Ph.D., and Koji Tanaka, MD, Ph.D., for their valuable assistance and for providing direction in the conduct of this study.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuoku, Kumamoto, Japan

    Naoya Yoshida MD, PhD, Tomo Horinouchi MD, Kojiro Eto MD, PhD & Hideo Baba MD, PhD

  2. Division of Translational Research and Advanced Treatment against Gastrointestinal Cancer, Kumamoto University, Kumamoto, Japan

    Naoya Yoshida MD, PhD

  3. Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan

    Yusuke Taniyama MD, PhD, Kozue Takahashi MD & Takashi Kamei MD, PhD

  4. Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan

    Kentaro Murakami MD, PhD & Hisahiro Matsubara MD, PhD

  5. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Shinya Shiraishi MD, PhD

Authors
  1. Naoya Yoshida MD, PhD
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  2. Yusuke Taniyama MD, PhD
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  3. Kentaro Murakami MD, PhD
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  4. Tomo Horinouchi MD
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  5. Kozue Takahashi MD
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  6. Shinya Shiraishi MD, PhD
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  7. Kojiro Eto MD, PhD
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  8. Takashi Kamei MD, PhD
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  9. Hisahiro Matsubara MD, PhD
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  10. Hideo Baba MD, PhD
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Corresponding author

Correspondence to Hideo Baba MD, PhD.

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Disclosure

Dr. Naoya Yoshida is affiliated to a department supported by Chugai Pharmaceutical Co., Ltd., and Yakuruto Honsya Co., Ltd., but declares no conflicts of interest regarding this research. The rest of the authors have no conflicts of interest or financial ties to disclose regarding this research.

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Yoshida, N., Taniyama, Y., Murakami, K. et al. Novel Criterion Using Esophageal Major and Minor Axes is Useful to Evaluate the Therapeutic Effect and Prognosis After Neoadjuvant Chemotherapy Followed by Surgery in Locally Advanced Esophageal Cancer. Ann Surg Oncol 28, 8474–8482 (2021). https://doi.org/10.1245/s10434-021-10314-5

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  • DOI: https://doi.org/10.1245/s10434-021-10314-5

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