gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Clinical Impact of assessment of histopathological response by residual tumor cell quantification in patients with neoadjuvant treated esophageal squamous cell carcinomas (ESCC)

Meeting Abstract

  • corresponding author presenting/speaker Björn Brücher - Chirurgische Klinik und Poliklinik, TU München, Deutschland
  • Karen Becker - Institut für Pathologie, TU München
  • Florian Lordick - Chirurgische Klinik und Poliklinik, TU München
  • Ulrich Fink - Chirurgische Klinik und Poliklinik, TU München
  • Mario Sarbia - Institut für Pathologie, TU München
  • Raymonde Busch - Institut für Statistik und Epidemiologie , TU München
  • Michael Molls - Institut für Strahlentherapie, TU München
  • Heinz Höfler - Institut für Pathologie, TU München
  • Jörg-Rüdiger Siewert - Chirurgische Klinik und Poliklinik, TU München

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP599

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Veröffentlicht: 20. März 2006

© 2006 Brücher et al.
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Purpose: To investigate histomorphological features as a response classification after neoadjuvant radiochemotherapy (RTx/CTx) and to correlate the results with clinical parameters, e.g. postoperative morbidity and mortality, survival, prognosis and recurrence in patients with locally advanced esophageal squamous cell carcinomas (ESCC).

Patients and Methods:Three-hundred-eleven patients with histologically proven intrathoracic locally advanced ESCC (cT3, cN0/+, cM0) located at or above the level of the tracheal bifurcation underwent preoperative combined simultaneous RTx/CTx in phase II trials followed by esophagectomy. Response to RTx/CTx was classified by percentage of viable residual tumor cells. Histopathological responders were classified by less than 10% residual tumor cells within the specimen compared to histopathological non-responders, who showed more than 10% residual tumor cells.

Results: Histopathological response was found to be correlated significantly with complete tumor resection status (R0-resection) (p<0.0001), ypT-category (p<0.0001), lymph node involvement (p<0.0001), lymphatic vessel invasion (p<0.001) and survival (p<0.0001). Multivariate Cox regression analysis revealed that the histopathological response classification by residual tumor cell quantification is an independent prognostic factor (p<0.0001). Non-responders show a higher postoperative pulmonary morbidity (p=0.01), a higher 30-day mortality rate (p=0.02) and a dismal survival compared to histopathological responders (p<0.0001).

Conclusions: The histopathological response evaluation based on the quantification of residual tumor cells provides meaningful information for assessment of the outcome of patients with esophageal squamous cell carcinoma who have undergone neoadjuvant radiochemotherapy.Histopathological responders seem to represent a subgroup of patients who benefit from neoadjuvant therapy followed by surgery.