title: Prediction of survival by tumor area on endosonography after definitive chemoradiotherapy for locally advanced squamous cell carcinoma of the esophagus.
abstract: BACKGROUND
  Definitive chemoradiotherapy (CRT) is a reasonable approach for patients with locally advanced esophageal cancer who are not surgical candidates. This study was performed to investigate whether endosonography (EUS) assessment of tumor area response is a useful prognostic marker in patients with squamous cell carcinoma (SCC) of the esophagus who receive definitive CRT.
  
  
  METHODS
  A total of 33 patients who received definitive CRT for locally advanced esophageal SCC were enrolled. The maximal transverse cross-sectional area of the tumor was measured before and after definitive therapy. EUS response was defined as a ≥50% reduction of the tumor area after definitive CRT.
  
  
  RESULTS
  Based on EUS evaluation, there were 20 nonresponders (60.6%) and 13 responders (39.4%). The median progression-free survival (PFS) was significantly longer in EUS responders than EUS nonresponders (p = 0.005). However, there was no statistical significance in overall survival according to EUS response (p = 0.120). During multivariate analysis, EUS response to definitive CRT was the only significant factor associated with PFS (p = 0.045), whereas EUS response to definitive CRT was not associated with overall survival (p = 0.221).
  
  
  CONCLUSIONS
  A reduction of the maximal cross-sectional tumor area measured by EUS correlates with a superior prognosis in patients with locally advanced SCC of the esophagus after definitive CRT.
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Choong Nam
authors.initials: CN
authors.lastname: Shim
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Song
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.forename: Hyunsoo
authors.initials: H
authors.lastname: Chung
authors.forename: Hyuk
authors.initials: H
authors.lastname: Lee
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Shin
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Jun Chul
authors.initials: JC
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D059248:Chemoradiotherapy; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies