title: Clinical parameters model for predicting pathologic complete response following preoperative chemoradiation in patients with esophageal cancer.
abstract: BACKGROUND
  Approximately 25% of patients with esophageal cancer (EC) who undergo preoperative chemoradiation, achieve a pathologic complete response (pathCR). We hypothesized that a model based on clinical parameters could predict pathCR with a high (≥60%) probability.
  
  
  METHODS
  We analyzed 322 patients with EC who underwent preoperative chemoradiation. All the patients had baseline and postchemoradiation positron emission tomography (PET) and pre- and postchemoradiation endoscopic biopsy. Logistic regression models were used for analysis, and cross-validation via the bootstrap method was carried out to test the model.
  
  
  RESULTS
  The 70 (21.7%) patients who achieved a pathCR lived longer (median overall survival [OS], 79.76 months) than the 252 patients who did not achieve a pathCR (median OS, 39.73 months; OS, P = 0.004; disease-free survival, P = 0.003). In a logistic regression analysis, the following parameters contributed to the prediction model: postchemoradiation PET, postchemoradiation biopsy, sex, histologic tumor grade, and baseline (EUS)T stage. The area under the receiver-operating characteristic curve was 0.72 (95% confidence interval [CI] 0.662-0.787); after the bootstrap validation with 200 repetitions, the bias-corrected AU-ROC was 0.70 (95% CI 0.643-0.728).
  
  
  CONCLUSIONS
  Our data suggest that the logistic regression model can predict pathCR with a high probability. This clinical model could complement others (biomarkers) to predict pathCR.
authors: Departments of Gastrointestinal Medical Oncology, Houston, USA. Electronic address: jajani@mdanderson.org.
authors: J A
authors: JA
authors: Ajani
authors: Departments of Thoracic and Cardiovascular Surgery, Houston, USA.
authors: A M
authors: AM
authors: Correa
authors: Departments of Thoracic and Cardiovascular Surgery, Houston, USA.
authors: W L
authors: WL
authors: Hofstetter
authors: Departments of Thoracic and Cardiovascular Surgery, Houston, USA.
authors: D C
authors: DC
authors: Rice
authors: Departments of Gastrointestinal Medical Oncology, Houston, USA.
authors: M A
authors: MA
authors: Blum
authors: Departments of Gastrointestinal Medical Oncology, Houston, USA.
authors: A
authors: A
authors: Suzuki
authors: Departments of Gastrointestinal Medical Oncology, Houston, USA.
authors: T
authors: T
authors: Taketa
authors: Departments of Radiation Oncology, Houston, USA.
authors: J
authors: J
authors: Welsh
authors: Departments of Radiation Oncology, Houston, USA.
authors: S H
authors: SH
authors: Lin
authors: Departments of Gastroenterology, Hepatology, and Nutrition, Houston, USA.
authors: J H
authors: JH
authors: Lee
authors: Departments of Gastroenterology, Hepatology, and Nutrition, Houston, USA.
authors: M S
authors: MS
authors: Bhutani
authors: Departments of Gastroenterology, Hepatology, and Nutrition, Houston, USA.
authors: W A
authors: WA
authors: Ross
authors: Departments of Pathology, Houston, USA.
authors: D M
authors: DM
authors: Maru
authors: Nuclear Medicine, Houston, USA.
authors: H A
authors: HA
authors: Macapinlac
authors: Departments of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, USA.
authors: J
authors: J
authors: Erasmus
authors: Departments of Radiation Oncology, Houston, USA.
authors: R
authors: R
authors: Komaki
authors: Departments of Thoracic and Cardiovascular Surgery, Houston, USA.
authors: R J
authors: RJ
authors: Mehran
authors: Departments of Thoracic and Cardiovascular Surgery, Houston, USA.
authors: A A
authors: AA
authors: Vaporciyan
authors: Departments of Thoracic and Cardiovascular Surgery, Houston, USA.
authors: S G
authors: SG
authors: Swisher
mesh_terms: D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D015999:Multivariate Analysis; D016019:Survival Analysis