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Predicting NICT Response With Radiological Dynamics in ESCC

May, 05, 2024 | Esophageal Cancer, Gastrointestinal Cancer

KEY TAKEAWAYS

  • The study aimed to investigate the efficacy of dynamic radiological features in predicting pCR following NICT plus esophagectomy for LA-ESCC.
  • Researchers noticed that dynamic radiological features serve as independent predictors of pCR in patients with LA-ESCC.

Neoadjuvant immunochemotherapy (NICT) plus esophagectomy has emerged as a promising treatment option for locally advanced esophageal squamous cell carcinoma (LA-ESCC). Pathologic complete response (pCR) is a key indicator associated with great efficacy and overall survival (OS). However, there needs to be more indicators for the reliable assessment of pCR.

Yuli Ruan and the team aimed to assess the utility of dynamic radiological features in predicting pCR after NICT for LA-ESCC.

They performed an inclusive analysis involving 192 patients diagnosed with LA-ESCC who underwent NICT between December 2019 and October 2023. Patients were categorized based on their pCR status, with 22.92% in the pCR group and 77.08% in the non-pCR group.

Radiological features from pretreatment and preoperative CT images were extracted for analysis. Logistic and COX regressions were employed to train models for predicting pathological response and prognosis, respectively.

About 4 selected radiological features were combined to construct an ESCC preoperative imaging score (ECPI-Score). Logistic models revealed independent associations of ECPI-Score and vascular sign with pCR, with an AUC of 0.918 in the training set and 0.862 in the validation set, respectively.

After grouping by ECPI score, a higher proportion of pCR was observed among the high-ECPI group and those with negative vascular signs. Kaplan Meier analysis demonstrated that recurrence-free survival (RFS) with negative vascular signs was significantly better than those with positive (P= 0.038), but not for OS (P= 0.310).

The study concluded that dynamic radiological features serve as independent predictors of pCR for LA-ESCC treated with NICT. These findings are expected to guide clinicians in formulating accurate treatment plans.

This work was sponsored by the National Natural Science Foundation of China, the Key R&D Project of Heilongjiang Province, and the National Cancer Center Climbing Fund.

Source: https://pubmed.ncbi.nlm.nih.gov/38762454/

Ruan Y, Ma Y, Ma M, et al. (2024). “Dynamic radiological features predict pathological response after neoadjuvant immunochemotherapy in esophageal squamous cell carcinoma.” J Transl Med. 2024 May 18;22(1):471. doi: 10.1186/s12967-024-05291-8. PMID: 38762454; PMCID: PMC11102630.

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