Should preoperative, post-chemoradiotherapy endoscopy be routine for esophageal cancer patients?

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
A ShaukatM Javle

Abstract

Chemoradiation therapy is used widely for locoregional esophageal cancer. Patients with persistent disease may benefit from surgery. Preoperative esophagoscopy can identify persistent tumor but its accuracy is uncertain. The primary objective of this study is to assess the extent of agreement between esophagoscopy and surgical pathology in patients treated with neoadjuvant chemoradiation. A retrospective chart review of patients who underwent chemoradiation, preoperative endoscopy and surgery from January 1996 to December 2002 was performed. Cohen's kappa statistic was used to measure the degree of agreement between findings at endoscopic biopsy and surgical pathology. Thirty cases were identified. All patients received chemoradiation followed by surgical resection. There was insufficient agreement between tumor size (kappa 0.25, standard error 0.17, P = 0.07) and appearance (kappa 0.19, standard error 0.18, P = 0.14). Preoperative endoscopy revealed atypia/inflammation in 15 cases and dysplasia in eight. Of these 23 cases, 11 were adenocarcinomas at surgery. Only nine patients had concurrence between surgical pathology and endoscopy. The positive and negative predictive values of esophagoscopy for identifying residual tumor we...Continue Reading

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Citations

Dec 8, 2009·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Sadamoto ZendaTetsuo Nishimura
Jan 18, 2013·Digestive Diseases and Sciences·Sajneet K Khangura, Bruce D Greenwald
Jan 19, 2018·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·F FujishimaH Sasano

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