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对于食道癌的病理完整反应后的长期瘤结果

Andrew J Sinnamon¹, Samir H Saeed², Allan A Lima Pereira²

¹Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA. Andrew.Sinnamon@moffitt.org.

Annals of surgical oncology

|November 5, 2025

概括

新辅助化疗或放射治疗后的病理完整反应 (pCR) 改善了食道癌患者的生存率,但复发仍然很常见. 一个新的风险评分有助于预测pCR患者的结果,指导进一步的治疗决策.

科学领域:

在瘤学瘤学.
胃肠病学胃肠病学
临床研究临床研究

背景情况:

新辅助化学辐射是局部晚期食道癌的标准治疗方法.
病理完整反应 (pCR) 率在腺癌 (AC) 和状细胞癌 (SCC) 组织学之间有显著差异.
对于 pCR 后的长期结果尚不清楚,因此需要进一步研究.

研究的目的:

评估pCR对新辅助化学辐射和食道癌食道切除术后长期存活的影响.
确定复发的预测因子,并为实现pCR的患者制定风险评分.

主要方法:

分析了830名患有局部晚期食道AC或SCC的患者,这些患者接受了新辅助化学辐射和切除治疗.
使用卡普兰-梅尔和考克斯模型评估无复发生存率 (RFS) 和整体生存率 (OS).
使用国家癌症数据库开发和外部验证复发风险评分.

主要成果:

37.1%的患者实现了pCR,与AC (34.2%) 相比,SCC (58.0%) 的比率更高.
pCR独立地与改善的OS (5年OS:56.2%对35.0%) 和RFS相关.
经验证的风险评分预测了PCR后的OS,低风险评分 (0-3) 的中位数OS为7.8年,高风险评分 (4-5) 的中位数OS为5.7年.

结论:

新辅助化学放射治疗后的pCR是食道癌生存的重要预测因素.
即使在实现pCR后,复发仍然是一个问题,特别是在AC组织学中.
对高风险pCR患者的辅助疗法进行进一步的研究是有必要的,以改善结果.

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