Nomogram for predicting pathologically complete response after neoadjuvant chemoradiotherapy for oesophageal cancer. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Toxopeus, Eelke Lucie Anne; Nieboer, Daan; Shapiro, Joel; Biermann, Katharina; van der Gaast, Ate; van Rij, Carolien M.; Steyerberg, Ewout Willem; van Lanschot, Joseph Jan Baptiste; Wijnhoven, Bas Peter Louis
• Is Part Of: Radiotherapy and oncology. Volume 115:Issue 3(2015:Jun.)
• Page Start: 392
• Page End: 398
• Publication Date: 2015-06
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.04.028
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background</title> <p id="sp0005">A pathologically complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) is seen in 30% of the patients with oesophageal cancer. The aim is to identify patient and tumour characteristics associated with a pCR and to develop a nomogram for the prediction of pCR.</p> </sec> <sec> <title id="st015">Patients and methods</title> <p id="sp0010">Patients who underwent nCRT followed by surgery were identified and response to nCRT was assessed according to a modified Mandard classification in the resection specimen. A model was developed with age, gender, histology and location of the tumour, differentiation grade, alcohol use, smoking, percentage weight loss, Charlson Comorbidity Index (CCI), cT-stage and cN-stage as potential predictors for pCR. Probability of pCR was studied via logistic regression. Performance of the prediction nomogram was quantified using the concordance statistic (<italic>c</italic>-statistic) and corrected for optimism.</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">A total of 381 patients were included. After surgery, 27.6% of the tumours showed a pCR. Female sex, squamous cell histology, poor differentiation grade, and low cT-stage were predictive for a pCR with a <italic>c</italic>-statistic of 0.64 (corrected for optimism).</p> </sec> <sec> <title id="st025">Conclusion</title> <p id="sp0020">A nomogram for the prediction of pathologically complete response after neoadjuvant chemoradiotherapy was developed, with a reasonable predictive power. This nomogram needs external validation before it can be used for individualised clinical decision-making.</p> </sec> </abstract>