Radiotherapy, squamous cell carcinoma predict positive response to therapy in esophageal cancer

A favourable pathologic response (FPR) is associated with improved overall survival following neoadjuvant therapy in patients with esophageal and gastroesophageal cancer (GEJ), reveal the results of a recent study. Of note, squamous cell carcinoma and radiation therapy-based protocol are significant predictors of FPR in these patients.

“Preoperative prediction of FPR could modify treatment plans,” the researchers said, yet “[n]o reliable method for predicting FPR exists.”

To identify preoperative predicting factors for FPR, a retrospective analysis was conducted in patients with esophageal and GEJ cancer who underwent esophagectomy following neoadjuvant therapy.

The research team identified the preoperative predictor factors for FPR using univariate and multivariate analyses. They also examined treatment response on overall survival using a comparison of Tumor Regression Grade (TRG).

A total of 121 patients were analysed, of which 82 (67.8 percent) were treated with neoadjuvant chemoradiation. FPR was noted in 60 patients (49.6 percent).

On univariate analysis, the following factors were found to be significantly associated with FPR: female sex, radiation therapy, squamous cell carcinoma, lack of signet ring feature, and FDG avidity post-treatment. Multivariate analysis revealed that only radiation therapy (odds ratio, 3.9) and squamous cell carcinoma (odds ratio, 4.0) were predictive of FPR.

Notably, overall survival was lower among patients who failed to achieve FPR to neoadjuvant therapy (p=0.027).