title: Clinical and pathologic evaluation of the effectiveness of neoadjuvant chemoradiation therapy in advanced esophageal cancer patients.
abstract: BACKGROUND
  Chemoradiation therapy (CRT) has the strongest antitumor effect against local tumors of esophageal cancer; however, no standard strategy has yet been established to achieve a clinical complete response (CR) after CRT. The aim of this study was to clarify when a decision can be made to perform further treatment for a clinical CR.
  
  
  METHODS
  We evaluated 78 patients that underwent an esophagectomy after neoadjuvant CRT in our department between 1998 and 2007. The study investigated the clinical and pathologic results of neoadjuvant CRT.
  
  
  RESULTS
  Of the 78 cases, 19 (24.3%) were a pathologic CR (Grade 3). Pathologic CR could be estimated in only 3 of 8 clinical CR cases (37.5%). On the other hand, 12 (20.7%) of the 58 clinical partial response (PR) cases achieved pathologic CR. Likewise, 4 cases (36.4%) achieved pathologic CR among the clinical no change/progressive disease (NC/PD) patients.
  
  
  CONCLUSIONS
  The clinical evaluation for CRT does not reflect the pathologic effectiveness and, even if clinical CR was achieved, viable cancer cells were still present at the primary site in the majority of the population.
authors.affiliation: Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Akutsu
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Masaya
authors.initials: M
authors.lastname: Uesato
authors.forename: Mikito
authors.initials: M
authors.lastname: Mori
authors.forename: Isamu
authors.initials: I
authors.lastname: Hoshino
authors.forename: Toru
authors.initials: T
authors.lastname: Shiratori
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Miyazawa
authors.forename: Hisao
authors.initials: H
authors.lastname: Ito
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome