000			03234nam a22004337a 4500
008			220511s20222022 xxu||||| |||| 00| 0 eng d
022			_a1091-255X
024			_a10.1007/s11605-022-05315-y [doi]
024			_a10.1007/s11605-022-05315-y [pii]
040			_aOvid MEDLINE(R)
099			_a35414141
245			_aCan Clinical Response Predict Pathologic Response Following Neoadjuvant Chemoradiation for Esophageal Cancer?.
251			_aJournal of Gastrointestinal Surgery. 2022 Apr 12
252			_aJ Gastrointest Surg. 2022 Apr 12
253			_aJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
260			_c2022
260			_fFY2022
260			_p2022 Apr 12
265			_saheadofprint
266			_d2022-05-11
520			_aCONCLUSIONS: Current restaging tools cannot reliably predict ypCR after nCRT. While multimodal restaging appears to be a more accurate predictor of ypCR than any testing modality alone, patients cannot reliably be advised to avoid an esophagectomy on the assumption that ycCR predicts ypCR at this time. Copyright © 2022. The Society for Surgery of the Alimentary Tract.
520			_aMETHODS: Patients undergoing esophagectomy following nCRT at three major institutions between 2005 and 2018 were reviewed. Restaging, including PET/CT, endoscopy with biopsy, and esophageal ultrasound (EUS), was performed to determine ycCR.
520			_aOBJECTIVES: Approximately 20-40% of patients with locally advanced esophageal cancer will achieve a pathologic complete response (ypCR) following neoadjuvant chemoradiotherapy (nCRT). Predicting ypCR based on a clinical complete response (ycCR) has been a challenge. This study assessed the correlation between ycCR and ypCR, as determined from esophagectomy specimens.
520			_aRESULTS: Six hundred sixty patients were included, with 93.3% with esophageal adenocarcinoma histology. Six hundred fifty-eight of these patients underwent PET, 304 EUS, and 584 underwent a biopsy. Following nCRT, 148 (22.4%) were found to have a ypCR. Only 12/32 (37.5%) determined to have a ycCR were found to have a ypCR, while 136/628 (21.6%) with a non-ycCR were found to have a ypCR (p 0.075). Individual modality PPV was 28% for PET, 54% for EUS, and 26% for biopsy. When PET was combined with EUS, 168 reports were concordant and the PPV of ypCR was 50%, though the number of patients was low (1/2). With all 3 re-staging modalities combined, the PPV and NPV both rose to 100%.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aMedStar General Surgery Residency
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aSurgery/Thoracic Surgery
657			_aJournal Article
700			_aDesale, Sameer
700			_aHolliday, Tyler
700			_aKhaitan, Puja G
790			_aBayley EM, Carroll A, Desale S, Hofstetter WL, Holliday T, Khaitan PG, Watson TJ, Zhou N
856			_uhttps://dx.doi.org/10.1007/s11605-022-05315-y _zhttps://dx.doi.org/10.1007/s11605-022-05315-y
942			_cART _dArticle
999			_c571 _d571