title: Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma.
abstract: BACKGROUND
  In this study, we evaluated the factors associated with a pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  Pre-nCRT parameters in ESCC patients treated between 1999 and 2006 were analyzed to identify predictors of pCR. All patients received 5-fluorouracil/cisplatin-based chemotherapy and external beam radiation followed by scheduled esophagectomy. Variables were analyzed using univariate and multivariate analyses with pCR as the dependent variable. Estimated pCR rate was calculated with a regression model.
  
  
  RESULTS
  Fifty-nine (20.9%) of 282 patients achieved pCR. Univariate analysis identified four patient factors (age, smoking status, drinking history and hypertension), one pre-nCRT parameter (tumor length) as significant predictors of pCR (all P <0.05). On multivariate analysis, tumor length ≤3 cm (favorable, odds ratio (OR): 4.85, P = 0.001), patient age >55 years (favorable, OR: 1.95, P = 0.035), and being a non-smoker (favorable, OR: 3.6, P = 0.003) were independent predictors of pCR. The estimated pCR rates based on a logistic regression including those three predictors were 71%, 35 to approximately 58%, 19 to approximately 38%, and 12% for patients with 3, 2, 1 and 0 predictors, respectively.
  
  
  CONCLUSIONS
  Age, smoking habit and tumor length were important pCR predictors. These factors may be used to predict outcomes for ESCC patients receiving nCRT, to develop risk-adapted treatment strategies, and to select patients who could participate in trials on new therapies.
authors.forename: Ren-Wen
authors.initials: RW
authors.lastname: Huang
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan. chaoyk@cgmh.org.tw.
authors.forename: Yin-Kai
authors.initials: YK
authors.lastname: Chao
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Wen
authors.forename: Hsien-Kun
authors.initials: HK
authors.lastname: Chang
authors.forename: Chen-Kan
authors.initials: CK
authors.lastname: Tseng
authors.forename: Sheng-Chieh
authors.initials: SC
authors.lastname: Chan
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D012307:Risk Factors; D012907:Smoking; D015996:Survival Rate
chemical_list: D002945:Cisplatin; D005472:Fluorouracil