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©The Author(s) 2022.
World J Gastrointest Endosc. May 16, 2022; 14(5): 320-334
Published online May 16, 2022. doi: 10.4253/wjge.v14.i5.320
Published online May 16, 2022. doi: 10.4253/wjge.v14.i5.320
Table 1 Patients’ characteristics
All population (n = 23) | NAC (n = 15) | CRT (n = 8) | |
Age (yr) | |||
Median (range) | 72 (43-81) | 72 (43-78) | 72 (49-81) |
Sex | |||
Male | 19 | 12 | 7 |
Female | 4 | 3 | 1 |
Tumor location | |||
Ut | 2 | 2 | 0 |
Mt | 15 | 8 | 7 |
Lt | 4 | 4 | 0 |
Ae | 2 | 1 | 1 |
Clinical T stage | |||
cT1b | 1 | 1 | 0 |
cT2 | 3 | 3 | 0 |
cT3 | 11 | 11 | 0 |
cT4a | 1 | 0 | 1 |
cT4b | 7 | 0 | 7 |
Chemotherapy regimen | |||
CF | 21 | 13 | 8 |
DCF | 2 | 2 | |
Total irradiation dose | |||
38-40Gy | 6 | 6 | |
60Gy | 2 | 2 | |
Time of surgery after therapy (d) | |||
Median (range) | 37 (31-61) | 36 (31-61) | 40 (35-57) |
Pathological T stage | |||
pT0 | 3 | 1 | 2 |
pT1a | 3 | 1 | 2 |
pT1b | 6 | 6 | 0 |
pT2 | 3 | 1 | 2 |
pT3 | 8 | 6 | 2 |
Pathological response | |||
Grade1 | 13 | 11 | 2 |
Grade2 | 7 | 3 | 4 |
Grade3 | 3 | 1 | 2 |
Table 2 Comparison Ultrasound for specimens uT stage to histological pT stage
Ultrasound T stages | pT0 | pT1a | pT1b | pT2 | pT3 | Total |
Pathological T stages after NAC and CRT | ||||||
uT0 | 0 | 1 | 1 | 0 | 0 | 2 |
uT1a | 0 | 0 | 0 | 0 | 0 | 0 |
uT1b | 0 | 0 | 4 | 0 | 0 | 4 |
uT2 | 1 | 1 | 1 | 2 | 0 | 5 |
uT3 | 2 | 1 | 0 | 1 | 8 | 12 |
Total | 3 | 3 | 6 | 3 | 8 | 23 |
Accuracy (%) | 0 | 0 | 67 | 67 | 100 | 61 |
Overstaging (%) | 100 | 67 | 17 | 33 | 0 | 30 |
Understaging (%) | 33 | 16 | 0 | 0 | 9 | |
Pathological T stages after NAC | ||||||
uT0 | 0 | 1 | 1 | 0 | 0 | 2 |
uT1a | 0 | 0 | 0 | 0 | 0 | 0 |
uT1b | 0 | 0 | 4 | 0 | 0 | 4 |
uT2 | 1 | 0 | 1 | 1 | 0 | 3 |
uT3 | 0 | 0 | 0 | 0 | 6 | 6 |
Total | 1 | 1 | 6 | 1 | 6 | 15 |
Accuracy (%) | 0 | 0 | 67 | 100 | 100 | 73 |
Overstaging (%) | 100 | 0 | 17 | 0 | 0 | 13 |
Understaging (%) | 100 | 17 | 0 | 0 | 13 | |
Pathological T stages after CRT | ||||||
uT0 | 0 | 0 | 0 | 0 | 0 | 0 |
uT1a | 0 | 0 | 0 | 0 | 0 | 0 |
uT1b | 0 | 0 | 0 | 0 | 0 | 0 |
uT2 | 0 | 1 | 0 | 1 | 0 | 2 |
uT3 | 2 | 1 | 0 | 1 | 2 | 6 |
Total | 2 | 2 | 0 | 2 | 2 | 8 |
Accuracy (%) | 0 | 0 | 0 | 50 | 100 | 38 |
Overstaging (%) | 100 | 100 | 0 | 50 | 0 | 62 |
Understaging (%) | 0 | 0 | 0 | 0 | 0 |
Table 3 Relationship between detection of residual tumor and clinicopathological factors
Detection of residual tumor | |||
Possible | Impossible | P | |
All, n (%) | 15 (75) | 5 (25) | |
Preoperative treatment, n (%) | |||
NAC | 11 (79) | 3 (21) | |
CRT | 4 (67) | 2 (33) | 0.613 |
Macroscopic type after neoadjuvant therapy, n (%) | |||
Ulcerative and protruding type | 11 (100) | 0 (0) | |
Superficial and SMT type | 4 (44) | 5 (56) | 0.008 |
Pathologic tumor size (mm) | |||
Median (range) | 42 (5-65) | 4 (2-34) | 0.008 |
Pathological T stage, n (%) | |||
pT1a/1b | 5 (56) | 4 (44) | |
pT2/3 | 10 (91) | 1 (9) | 0.127 |
Pathological response, n (%) | |||
Grade1 | 12 (92) | 1 (8) | |
Grade2 | 3 (43) | 4 (57) | 0.031 |
Table 4 Echoic characteristics of the detected residual tumor
All population (n = 15) | NAC (n = 11) | CRT (n = 4) | P | |
Border | ||||
Regular | 10 | 10 | 0 | |
Irregular | 5 | 1 | 4 | 0.004 |
Echogenicity | ||||
Hypoechoic | 5 | 5 | 0 | |
Hypo and isoechoic (mixed) | 10 | 6 | 4 | 0.231 |
Table 5 Patients’ characteristics in study 2
pT0/1 (n = 10) | pT2/3 (n = 10) | P | |
Age (yr) | |||
Median (range) | 73 (52-79) | 72 (43-81) | 0.94 |
Sex | |||
Male/Female | 9/1 | 7/3 | 0.582 |
Tumor location | |||
Ut, Mt, Lt/Ae | 10/0 | 8/2 | 0.473 |
Clinical T stage | |||
cT2, 3/cT4a, b | 6/4 | 6/4 | 1 |
Preoperative treatment | |||
NAC/CRT | 6/4 | 6/4 | 1 |
Chemo regimen | |||
CF/DCF | 9/1 | 9/1 | 1 |
Total irradiation dose | |||
38-40Gy/60Gy | 2/2 | 4/0 | 0.429 |
Time of EUS after therapy (d) | |||
Median (range) | 37 (21-49) | 29 (14-50) | 0.172 |
Time of surgery after therapy (d) | |||
Median (range) | 41 (34-57) | 37 (31-61) | 0.471 |
- Citation: Yonemoto S, Uesato M, Nakano A, Murakami K, Toyozumi T, Maruyama T, Suito H, Tamachi T, Kato M, Kainuma S, Matsusaka K, Matsubara H. Why is endosonography insufficient for residual diagnosis after neoadjuvant therapy for esophageal cancer? Solutions using muscle layer evaluation. World J Gastrointest Endosc 2022; 14(5): 320-334
- URL: https://www.wjgnet.com/1948-5190/full/v14/i5/320.htm
- DOI: https://dx.doi.org/10.4253/wjge.v14.i5.320