Prognostic value of histopathological regression in 850 neoadjuvantly treated oesophagogastric adenocarcinomas

• Published in: British journal of cancer Vol. 110; no. 7; pp. 1712 - 1720
• Main Authors: Schmidt, T, Sicic, L, Blank, S, Becker, K, Weichert, W, Bruckner, T, Parakonthun, T, Langer, R, Büchler, M W, Siewert, J-R, Lordick, F, Ott, K
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.04.2014; Nature Publishing Group
• Subjects: 692/699/67/1059/99; 692/699/67/1504/1477; 692/700/1750; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer therapies; Chemotherapy; Clinical Study; Drug Resistance; Epidemiology; Esophageal Neoplasms - pathology; Esophageal Neoplasms - therapy; Female; Humans; Localization; Male; Medical prognosis; Medical sciences; Middle Aged; Molecular Medicine; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Multivariate analysis; Neoadjuvant Therapy; Neoplasm Staging; Oncology; Pathology; Patients; Predictive Value of Tests; Prognosis; Remission Induction; Response rates; Retrospective Studies; Stomach Neoplasms - pathology; Stomach Neoplasms - therapy; Surgery; Surgical outcomes; Tumor Burden; Tumors; Young Adult; Germany; histopathological regression; neoadjuvant treated; localisation; signet ring cell cancer; prognostic factors; oesophagogastric adenocarcinomas; multivariate analysis; surgery; Adenocarcinoma; Prognosis; Regression; Malignant tumor; Multivariate analysis; Neoadjuvant treatment; Anatomic pathology; Cancerology; Histopathology; Ring; Surgery; Cell; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2014.94

Background: Recently, histopathological tumour regression, prevalence of signet ring cells, and localisation were reported as prognostic factors in neoadjuvantly treated oesophagogastric (junctional and gastric) cancer. This exploratory retrospective study analyses independent prognostic factors within a large patient cohort after preoperative chemotherapy including clinical and histopathological factors. Methods: In all, 850 patients presenting with oesophagogastric cancer staged cT3/4 Nany cM0/x were treated with neoadjuvant chemotherapy followed by resection in two academic centres. Patient data were documented in a prospective database and retrospectively analysed. Results: Of all factors prognostic on univariate analysis, only clinical response, complications, ypTNM stage, and R category were independently prognostic ( P <0.01) on multivariate analysis. Tumour localisation and signet ring cells were independently prognostic only when investigator-dependent clinical response evaluation was excluded from the multivariate model. Histopathological tumour regression correlates with tumour grading, Laurén classification, clinical response, ypT, ypN, and R categories but was not identified as an independent prognostic factor. Within R0-resected patients only surgical complications and ypTNM stage were independent prognostic factors. Conclusions: Only established prognostic factors like ypTNM stage, R category, and complications were identified as independent prognostic factors in resected patients after neoadjuvant chemotherapy. In contrast, histopathological tumour regression was not found as an independent prognostic marker.