Abstract
Background: Although a substantial proportion of patients undergoing neoadjuvant chemoradiation for invasive esophageal cancer develop a pathologic complete response (pCR), these patients nonetheless have a poor 5-year survival rate. We hypothesized that routine pathologic examination fails to identify some residual cancer. Methods: Patients undergoing esophagectomy for cancer at 2 tertiary care centers were identified. Archived tumor blocks were retrieved for patients with pCR, sectioned at 50-μm intervals and reexamined for residual cancer. Results: Seventy patients underwent neoadjuvant chemoradiation. Tumor blocks were available for 23 of 26 complete responders. A total of 159 blocks were reexamined. One patient was found to have a possible focus of residual invasive adenocarcinoma versus high-grade dysplasia. The remaining 22 patients had no residual disease. Conclusions: A more aggressive examination protocol for postchemoradiation esophagectomy specimens may not result in significant upstaging. Inadequate pathologic examination is likely not a major factor in the suboptimal survival in patients with pCR.
Original language | English (US) |
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Pages (from-to) | 614-617 |
Number of pages | 4 |
Journal | American journal of surgery |
Volume | 193 |
Issue number | 5 SPEC. ISS. |
DOIs | |
State | Published - May 2007 |
Keywords
- Esophageal cancer
- Neoadjuvant chemoradiation
- Pathologic complete response
- Staging
ASJC Scopus subject areas
- Surgery