期刊
ANNALS OF ONCOLOGY
卷 23, 期 10, 页码 2638-2642出版社
OXFORD UNIV PRESS
DOI: 10.1093/annonc/mds210
关键词
chemoradiation; esophageal cancer; esophageal preservation; nomogram; prediction of response
类别
资金
- Dallas family fund
- Park family fund
- Smith family fund
- Cantu family fund
- Kevin Fund
- Sultan Fund
- River Creek Foundation
- Aaron and Martha Schecter Private Foundation
- Multidisciplinary Research Program at MD Anderson Cancer Center, Houston, USA
- National Institutes of Health through MD Anderson's Cancer Center (National Cancer Institute, Bethesda, USA) [CA016672]
Approximately 25% of patients with esophageal cancer (EC) who undergo preoperative chemoradiation, achieve a pathologic complete response (pathCR). We hypothesized that a model based on clinical parameters could predict pathCR with a high (>= 60%) probability. We analyzed 322 patients with EC who underwent preoperative chemoradiation. All the patients had baseline and postchemoradiation positron emission tomography (PET) and pre- and postchemoradiation endoscopic biopsy. Logistic regression models were used for analysis, and cross-validation via the bootstrap method was carried out to test the model. The 70 (21.7%) patients who achieved a pathCR lived longer (median overall survival [OS], 79.76 months) than the 252 patients who did not achieve a pathCR (median OS, 39.73 months; OS, P = 0.004; disease-free survival, P = 0.003). In a logistic regression analysis, the following parameters contributed to the prediction model: postchemoradiation PET, postchemoradiation biopsy, sex, histologic tumor grade, and baseline T-EUS stage. The area under the receiver-operating characteristic curve was 0.72 (95% confidence interval [CI] 0.662-0.787); after the bootstrap validation with 200 repetitions, the bias-corrected AU-ROC was 0.70 (95% CI 0.643-0.728). Our data suggest that the logistic regression model can predict pathCR with a high probability. This clinical model could complement others (biomarkers) to predict pathCR.
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