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Clinical parameters model for predicting pathologic complete response following preoperative chemoradiation in patients with esophageal cancer.


ABSTRACT: 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 (EUS)T 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.

SUBMITTER: Ajani JA 

PROVIDER: S-EPMC3457750 | biostudies-other | 2012 Oct

REPOSITORIES: biostudies-other

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Clinical parameters model for predicting pathologic complete response following preoperative chemoradiation in patients with esophageal cancer.

Ajani J A JA   Correa A M AM   Hofstetter W L WL   Rice D C DC   Blum M A MA   Suzuki A A   Taketa T T   Welsh J J   Lin S H SH   Lee J H JH   Bhutani M S MS   Ross W A WA   Maru D M DM   Macapinlac H A HA   Erasmus J J   Komaki R R   Mehran R J RJ   Vaporciyan A A AA   Swisher S G SG  

Annals of oncology : official journal of the European Society for Medical Oncology 20120724 10


<h4>Background</h4>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.<h4>Patients and methods</h4>We analyzed 322 patients with EC who underwent preoperative chemoradiation. All the patients had baseline and postchemoradiation positron emission tomography (PET) and pre- and postchemoradiatio  ...[more]

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