Accuracy of pathologic examination in detection of complete response after chemoradiation for esophageal cancer

Eugene Y. Chang, Christina A. Smith, Christopher Corless, Charles Thomas, John Hunter, Blair A. Jobe

Research output: Contribution to journalArticle

12 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)614-617
Number of pages4
JournalAmerican Journal of Surgery
Volume193
Issue number5 SPEC. ISS.
DOIs
StatePublished - May 2007

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Esophageal Neoplasms
Esophagectomy
Residual Neoplasm
Neoplasms
Tertiary Care Centers
Adenocarcinoma
Survival Rate
Survival

Keywords

  • Esophageal cancer
  • Neoadjuvant chemoradiation
  • Pathologic complete response
  • Staging

ASJC Scopus subject areas

  • Surgery

Cite this

Accuracy of pathologic examination in detection of complete response after chemoradiation for esophageal cancer. / Chang, Eugene Y.; Smith, Christina A.; Corless, Christopher; Thomas, Charles; Hunter, John; Jobe, Blair A.

In: American Journal of Surgery, Vol. 193, No. 5 SPEC. ISS., 05.2007, p. 614-617.

Research output: Contribution to journalArticle

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AU - Thomas, Charles

AU - Hunter, John

AU - Jobe, Blair A.

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AB - 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.

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