PD07.05. Tumor Enlargement on CT During Neoadjuvant Chemotherapy Predicts Poor Prognosis After Esophagectomy

Clicks: 1
ID: 325670
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #92 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 453 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background Although there have been reports on the use of PET/CT for evaluating the therapeutic effects of preoperative neoadjuvant chemotherapy for esophageal cancer, issues remain regarding insurance coverage. Additionally, the histopathological evaluation after resection is based on the percentage of cancer cells in tissue sections, so when chemotherapy causes the entire tumor to shrink, there can be a discrepancy with the clinical impression. On the other hand, evaluation using CT after chemotherapy is widely practiced in routine clinical care, and thus, its usefulness for predicting recurrence needs to be examined. Methods Among 314 patients who underwent thoracic esophagectomy between 2007 and 2024, 137 with clinical stage II–III disease treated with neoadjuvant chemotherapy were retrospectively analyzed. Changes in tumor size of the primary lesion and metastatic lymph nodes on CT were evaluated before and after chemotherapy. In the CT scans for each course of chemotherapy, “Tumor enlargement” was defined as an increase of 20% or more compared to the previous CT, or as enlargement of lymph nodes. Patients were classified into two groups according to the presence or absence of tumor enlargement. Associations between tumor enlargement and relapse-free survival (RFS), recurrence patterns, and clinicopathological factors were examined using Cox proportional hazards models. Results The median age was 66 years. Forty-five patients received doublet chemotherapy with 5FU/CDDP, while 92 patients received triplet therapy including Docetaxel. The numbers for the shrinkage, no change, and enlargement groups were 100, 13, and 24, respectively. All patients underwent radical esophagectomy. hen relapse-free survival was analyzed, the enlargement group had significantly poorer outcomes compared to the no change and shrinkage groups (p=0.003). Although no associations were found between the groups and frequency of mediastinal recurrence, the enlargement group had a significantly higher rate of distant metastases (p=0.005). In univariate analysis using proportional hazards, in addition to UICC pathological stage classification, presence of lymphatic invasion, presence of vascular invasion, and histological effect grade 0/1, tumor enlargement after chemotherapy was also extracted as a predictor for relapse-free survival. In multivariate analysis using these five factors, alongside pathological classification (p=0.007), tumor enlargement after chemotherapy was identified as an independent predictor (p=0.016). Conclusion This study aimed to determine the clinical significance of tumor enlargement on CT during neoadjuvant chemotherapy in patients undergoing esophagectomy for clinical stage II–III esophageal cancer. Although tumor enlargement during preoperative neoadjuvant chemotherapy did not affect the radical resection itself, it was associated with a significantly shorter relapse-free survival and an increased risk of distant metastasis. Tumor enlargement during preoperative chemotherapy was considered to be a factor in considering postoperative adjuvant therapy.
Reference Key
openalex_W7203880170 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Kengo Kanetaka, Shinichiro Kobayashi, Shunsuke Murakami, Kentaro Kubo, Kunihito Matsuguma, Yasumasa Hashimoto, Keiko Hamasaki, Junichi Arai, Kazuma Kobayashi, Susumu Eguchi
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.127
URL
https://doi.org/10.1093/dote/doag077.127
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.