Can CT-PET and Endoscopic Assessment Post-Neoadjuvant Chemoradiotherapy Predict Residual Disease in Esophageal Cancer?
OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC). DESIGN:A prospective cohort study. BACKGROUND:nCRT is increasingly standard of care in...
Gespeichert in:
| Veröffentlicht in: | Annals of surgery 2016-11, Vol.264 (5), p.831-838 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 838 |
|---|---|
| container_issue | 5 |
| container_start_page | 831 |
| container_title | Annals of surgery |
| container_volume | 264 |
| creator | Heneghan, Helen M Donohoe, Claire Elliot, Jessie Ahmed, Zuhair Malik, Vinod Ravi, Narayamasamy Reynolds, John V |
| description | OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC).
DESIGN:A prospective cohort study.
BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a surrogate for excellent outcome. Predicting pCR before surgery, with metabolic imaging and endoscopy, may spare patients’ operative intervention.
METHODS:One hundred thirty-eight consecutive patients [mean age 61 ± 8, 99 male (72%), 103 (75%) adenocarcinoma] underwent nCRT with CT-PET and endoscopy 4 to 6 weeks later, and surgery subsequently. A complete metabolic response (cMR) was defined as SUVmax of |
| doi_str_mv | 10.1097/SLA.0000000000001902 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835418951</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835418951</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3480-41e201ea4a1f0faa7a99b6f431567e6346db00e58c7ca12b750d4117215b11dc3</originalsourceid><addsrcrecordid>eNpdkFtv1DAQhS1ERZfCP0DIj7y4eBInTp7QKiwXaUVXZXmOHHtCUpI4eJJW_fcYbbmolkaWj86c8XyMvQJ5CbLUb7_ut5fyvwOlTJ6wDWRJIQCUfMo2UU2FKtPknD0nuokeVUj9jJ0nWiuQIDfstjITr47isDtyMzm-m5wn6-fe8i0REo04LfzgaRFf0Bt3s96aKFQdjj4Y1_ulw2Dme34I6Hq78Guk3q1m4O97QkPI-4nvyM-d-Y5RjeMshncv2FlrBsKXD_cF-_Zhd6w-if3Vx8_Vdi9sGr8qFGAiAY0y0MrWGG3KsslblUKWa8xTlbtGSswKq62BpNGZdApAJ5A1AM6mF-zNKXcO_ueKtNRjTxaHwUzoV6qhSDMFRZlBtKqT1QZPFLCt59CPJtzXIOvfxOtIvH5MPLa9fpiwNiO6v01_EP_LvfPDgoF-DOsdhrqLNJbulJdnhYh75gDxIWIlMv0FfSqK3g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835418951</pqid></control><display><type>article</type><title>Can CT-PET and Endoscopic Assessment Post-Neoadjuvant Chemoradiotherapy Predict Residual Disease in Esophageal Cancer?</title><source>MEDLINE</source><source>PubMed Central</source><source>Journals@Ovid Complete</source><creator>Heneghan, Helen M ; Donohoe, Claire ; Elliot, Jessie ; Ahmed, Zuhair ; Malik, Vinod ; Ravi, Narayamasamy ; Reynolds, John V</creator><creatorcontrib>Heneghan, Helen M ; Donohoe, Claire ; Elliot, Jessie ; Ahmed, Zuhair ; Malik, Vinod ; Ravi, Narayamasamy ; Reynolds, John V</creatorcontrib><description>OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC).
DESIGN:A prospective cohort study.
BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a surrogate for excellent outcome. Predicting pCR before surgery, with metabolic imaging and endoscopy, may spare patients’ operative intervention.
METHODS:One hundred thirty-eight consecutive patients [mean age 61 ± 8, 99 male (72%), 103 (75%) adenocarcinoma] underwent nCRT with CT-PET and endoscopy 4 to 6 weeks later, and surgery subsequently. A complete metabolic response (cMR) was defined as SUVmax of <4. A complete endoscopic response (cER) was no residual mucosal abnormality. The association of pCR with cMR and cER was analyzed.
RESULTS:pCR was achieved in 30 patients (22%); 37% SCC and 17% adenocarcinoma. A cMR was evident in 63 (46%), of whom 17 (27%) had a pCR and 17(27%) were ypN+. A cER was observed in 45 (33%). The Spearman correlation for cER and cMR was 0.066 (P = 0.479), for cER and pCR was 0.004 (P = 0.969), and cMR and pCR –0.120 (P = 0.160). The sensitivity, specificity, positive predictive value, and negative predictive value of cMR was 57%, 57%, 27%, and 82%, respectively, and for combined cMR and cER was 24%, 83%, 28%, and 79%, respectively.
CONCLUSIONS:The prediction of pCR through CT-PET and endoscopy independently or combined is limited by low sensitivity and poor positive predictive value. Protocols to avoid surgery in patients with apparent complete clinical complete based on these criteria should be adopted with considerable caution.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0000000000001902</identifier><identifier>PMID: 27741010</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell - diagnostic imaging ; Carcinoma, Squamous Cell - therapy ; Chemoradiotherapy ; Endoscopy ; Esophageal Neoplasms - diagnostic imaging ; Esophageal Neoplasms - therapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm, Residual ; Positron Emission Tomography Computed Tomography ; Predictive Value of Tests ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Annals of surgery, 2016-11, Vol.264 (5), p.831-838</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3480-41e201ea4a1f0faa7a99b6f431567e6346db00e58c7ca12b750d4117215b11dc3</citedby><cites>FETCH-LOGICAL-c3480-41e201ea4a1f0faa7a99b6f431567e6346db00e58c7ca12b750d4117215b11dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27741010$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heneghan, Helen M</creatorcontrib><creatorcontrib>Donohoe, Claire</creatorcontrib><creatorcontrib>Elliot, Jessie</creatorcontrib><creatorcontrib>Ahmed, Zuhair</creatorcontrib><creatorcontrib>Malik, Vinod</creatorcontrib><creatorcontrib>Ravi, Narayamasamy</creatorcontrib><creatorcontrib>Reynolds, John V</creatorcontrib><title>Can CT-PET and Endoscopic Assessment Post-Neoadjuvant Chemoradiotherapy Predict Residual Disease in Esophageal Cancer?</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC).
DESIGN:A prospective cohort study.
BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a surrogate for excellent outcome. Predicting pCR before surgery, with metabolic imaging and endoscopy, may spare patients’ operative intervention.
METHODS:One hundred thirty-eight consecutive patients [mean age 61 ± 8, 99 male (72%), 103 (75%) adenocarcinoma] underwent nCRT with CT-PET and endoscopy 4 to 6 weeks later, and surgery subsequently. A complete metabolic response (cMR) was defined as SUVmax of <4. A complete endoscopic response (cER) was no residual mucosal abnormality. The association of pCR with cMR and cER was analyzed.
RESULTS:pCR was achieved in 30 patients (22%); 37% SCC and 17% adenocarcinoma. A cMR was evident in 63 (46%), of whom 17 (27%) had a pCR and 17(27%) were ypN+. A cER was observed in 45 (33%). The Spearman correlation for cER and cMR was 0.066 (P = 0.479), for cER and pCR was 0.004 (P = 0.969), and cMR and pCR –0.120 (P = 0.160). The sensitivity, specificity, positive predictive value, and negative predictive value of cMR was 57%, 57%, 27%, and 82%, respectively, and for combined cMR and cER was 24%, 83%, 28%, and 79%, respectively.
CONCLUSIONS:The prediction of pCR through CT-PET and endoscopy independently or combined is limited by low sensitivity and poor positive predictive value. Protocols to avoid surgery in patients with apparent complete clinical complete based on these criteria should be adopted with considerable caution.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Squamous Cell - diagnostic imaging</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Chemoradiotherapy</subject><subject>Endoscopy</subject><subject>Esophageal Neoplasms - diagnostic imaging</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm, Residual</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkFtv1DAQhS1ERZfCP0DIj7y4eBInTp7QKiwXaUVXZXmOHHtCUpI4eJJW_fcYbbmolkaWj86c8XyMvQJ5CbLUb7_ut5fyvwOlTJ6wDWRJIQCUfMo2UU2FKtPknD0nuokeVUj9jJ0nWiuQIDfstjITr47isDtyMzm-m5wn6-fe8i0REo04LfzgaRFf0Bt3s96aKFQdjj4Y1_ulw2Dme34I6Hq78Guk3q1m4O97QkPI-4nvyM-d-Y5RjeMshncv2FlrBsKXD_cF-_Zhd6w-if3Vx8_Vdi9sGr8qFGAiAY0y0MrWGG3KsslblUKWa8xTlbtGSswKq62BpNGZdApAJ5A1AM6mF-zNKXcO_ueKtNRjTxaHwUzoV6qhSDMFRZlBtKqT1QZPFLCt59CPJtzXIOvfxOtIvH5MPLa9fpiwNiO6v01_EP_LvfPDgoF-DOsdhrqLNJbulJdnhYh75gDxIWIlMv0FfSqK3g</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Heneghan, Helen M</creator><creator>Donohoe, Claire</creator><creator>Elliot, Jessie</creator><creator>Ahmed, Zuhair</creator><creator>Malik, Vinod</creator><creator>Ravi, Narayamasamy</creator><creator>Reynolds, John V</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201611</creationdate><title>Can CT-PET and Endoscopic Assessment Post-Neoadjuvant Chemoradiotherapy Predict Residual Disease in Esophageal Cancer?</title><author>Heneghan, Helen M ; Donohoe, Claire ; Elliot, Jessie ; Ahmed, Zuhair ; Malik, Vinod ; Ravi, Narayamasamy ; Reynolds, John V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3480-41e201ea4a1f0faa7a99b6f431567e6346db00e58c7ca12b750d4117215b11dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Squamous Cell - diagnostic imaging</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Chemoradiotherapy</topic><topic>Endoscopy</topic><topic>Esophageal Neoplasms - diagnostic imaging</topic><topic>Esophageal Neoplasms - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm, Residual</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heneghan, Helen M</creatorcontrib><creatorcontrib>Donohoe, Claire</creatorcontrib><creatorcontrib>Elliot, Jessie</creatorcontrib><creatorcontrib>Ahmed, Zuhair</creatorcontrib><creatorcontrib>Malik, Vinod</creatorcontrib><creatorcontrib>Ravi, Narayamasamy</creatorcontrib><creatorcontrib>Reynolds, John V</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heneghan, Helen M</au><au>Donohoe, Claire</au><au>Elliot, Jessie</au><au>Ahmed, Zuhair</au><au>Malik, Vinod</au><au>Ravi, Narayamasamy</au><au>Reynolds, John V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can CT-PET and Endoscopic Assessment Post-Neoadjuvant Chemoradiotherapy Predict Residual Disease in Esophageal Cancer?</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2016-11</date><risdate>2016</risdate><volume>264</volume><issue>5</issue><spage>831</spage><epage>838</epage><pages>831-838</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><abstract>OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC).
DESIGN:A prospective cohort study.
BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a surrogate for excellent outcome. Predicting pCR before surgery, with metabolic imaging and endoscopy, may spare patients’ operative intervention.
METHODS:One hundred thirty-eight consecutive patients [mean age 61 ± 8, 99 male (72%), 103 (75%) adenocarcinoma] underwent nCRT with CT-PET and endoscopy 4 to 6 weeks later, and surgery subsequently. A complete metabolic response (cMR) was defined as SUVmax of <4. A complete endoscopic response (cER) was no residual mucosal abnormality. The association of pCR with cMR and cER was analyzed.
RESULTS:pCR was achieved in 30 patients (22%); 37% SCC and 17% adenocarcinoma. A cMR was evident in 63 (46%), of whom 17 (27%) had a pCR and 17(27%) were ypN+. A cER was observed in 45 (33%). The Spearman correlation for cER and cMR was 0.066 (P = 0.479), for cER and pCR was 0.004 (P = 0.969), and cMR and pCR –0.120 (P = 0.160). The sensitivity, specificity, positive predictive value, and negative predictive value of cMR was 57%, 57%, 27%, and 82%, respectively, and for combined cMR and cER was 24%, 83%, 28%, and 79%, respectively.
CONCLUSIONS:The prediction of pCR through CT-PET and endoscopy independently or combined is limited by low sensitivity and poor positive predictive value. Protocols to avoid surgery in patients with apparent complete clinical complete based on these criteria should be adopted with considerable caution.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27741010</pmid><doi>10.1097/SLA.0000000000001902</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-4932 |
| ispartof | Annals of surgery, 2016-11, Vol.264 (5), p.831-838 |
| issn | 0003-4932 1528-1140 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1835418951 |
| source | MEDLINE; PubMed Central; Journals@Ovid Complete |
| subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - therapy Adult Aged Aged, 80 and over Carcinoma, Squamous Cell - diagnostic imaging Carcinoma, Squamous Cell - therapy Chemoradiotherapy Endoscopy Esophageal Neoplasms - diagnostic imaging Esophageal Neoplasms - therapy Female Humans Male Middle Aged Neoadjuvant Therapy Neoplasm, Residual Positron Emission Tomography Computed Tomography Predictive Value of Tests Retrospective Studies Treatment Outcome |
| title | Can CT-PET and Endoscopic Assessment Post-Neoadjuvant Chemoradiotherapy Predict Residual Disease in Esophageal Cancer? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T04%3A28%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Can%20CT-PET%20and%20Endoscopic%20Assessment%20Post-Neoadjuvant%20Chemoradiotherapy%20Predict%20Residual%20Disease%20in%20Esophageal%20Cancer?&rft.jtitle=Annals%20of%20surgery&rft.au=Heneghan,%20Helen%20M&rft.date=2016-11&rft.volume=264&rft.issue=5&rft.spage=831&rft.epage=838&rft.pages=831-838&rft.issn=0003-4932&rft.eissn=1528-1140&rft_id=info:doi/10.1097/SLA.0000000000001902&rft_dat=%3Cproquest_cross%3E1835418951%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1835418951&rft_id=info:pmid/27741010&rfr_iscdi=true |