AI Article Synopsis
- This study investigated how the desmoplastic reaction (DR) affects the prognosis of patients with esophageal squamous cell carcinoma (ESCC) who underwent neoadjuvant therapies like chemotherapy or chemoradiotherapy.
- Out of 153 patients, those with intermediate or immature DR had significantly lower 5-year disease-specific survival rates compared to patients with mature DR, indicating that DR classification is a critical prognostic factor.
- The research found that DR serves as an independent risk factor for disease-specific survival in both groups of patients, emphasizing its importance in assessing treatment outcomes for ESCC.
Article Abstract
Aim: This study aimed to examine the prognostic value of desmoplastic reaction (DR) in esophageal squamous cell carcinoma (ESCC), particularly in patients who received neoadjuvant therapy, such as chemotherapy (NAC) or chemoradiotherapy (NACRT).
Method: In total, 153 patients with pStage II/III ESCC were included in this study. Ninety-one patients received neoadjuvant therapy (NAC, 70; NACRT, 21). Patients were classified according to three DR categories based on the presence of keloid-like collagen and/or myxoid stroma.
Results: In total, 50, 50, and 53 patients were classified as having mature, intermediate, and immature DR, respectively. The weighted kappa coefficient was 0.623 in the patients with preoperative treatments and 0.782, in those without. The 5-year disease-specific survival (DSS) rates in patients with intermediate/immature DR was significantly worse than those with mature DR (40.7% vs. 73.3%, p < 0.001). Similarly, the 5-year DSS rate in patients with intermediate/immature DR was significantly worse than those with mature DR in a study of patients who received neoadjuvant therapy (46.7% vs. 71.2%, p = 0.009). Multivariate analysis revealed that DR (hazard ratio [HR]: 3.15, 95% confidence interval [CI] 1.58-6.27, p = 0.001), along with N factors, was an independent risk factor for DSS. Moreover, multivariate analysis of patients who received neoadjuvant therapy revealed only DR (HR: 2.47, 95% CI 1.02-5.96, p = 0.045) as independent risk factors for DSS.
Conclusion: The DR classification was a valuable prognostic factor not only in the ESCC patients without neoadjuvant therapy but also in those with neoadjuvant therapy.
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| http://dx.doi.org/10.1007/s10388-023-00996-z | DOI Listing |
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