Abstract
Purpose
The accuracy of endoscopic esophageal biopsy after neoadjuvant chemoradiotherapy (nCRT)
remains suboptimal. We retrospectively examined the factors that may affect the diagnostic
accuracy of post-nCRT endoscopic biopsy in patients with esophageal squamous cell
carcinoma (ESCC).
Materials and methods
A total of 213 ESCC patients were enrolled. Biopsy findings were cross-checked against
the final pathology outcomes (ypT0 versus non-ypT0) to assess their accuracy. The independent predictors of diagnostic accuracy
were identified by multivariate logistic regression analysis.
Results
Post-nCRT endoscopic biopsy results were diagnostically consistent with the final
pathology outcomes in 116 (54.5%) patients. Multivariate logistic regression analysis
identified a long time interval between the completion of nCRT and the endoscopic
examination as the only factor independently associated with a higher diagnostic accuracy.
Receiver operating characteristic curve analysis showed that the optimal cutoff value
for the time interval between nCRT completion and endoscopic biopsy was 45 days. The
estimated diagnostic accuracies of biopsies performed before and after the optimal
cutoff time were 49.1% and 72.9%, respectively.
Conclusions
Endoscopic biopsies performed ≥45 days after nCRT are associated with a higher diagnostic
accuracy. This time cutoff may serve as a reference to inform the choice of the optimal
treatment strategy following nCRT, especially among complete responders in whom surgery
withholding is being considered.
Keywords
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Article info
Publication history
Published online: October 16, 2017
Accepted:
September 25,
2017
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
