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Remarkable response as a new indicator for endoscopic evaluation of local efficacy of non-surgical treatments for esophageal cancer

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Abstract

In Japan, standard of care of the patients with resectable esophageal cancer is neoadjuvant chemotherapy (NAC) followed by esophagectomy. Patients unfitted for surgery or with unresectable locally advanced esophageal cancer are generally indicated with definitive chemoradiotherapy (CRT). Local disease control is undoubtful important for the management of patients with esophageal cancer, therefore endoscopic evaluation of local efficacy after non-surgical treatments must be essential. The significant shrink of primary site after NAC has been reported as a good indicator of pathological good response as well as favorable survival outcome after esophagectomy. And patients who could achieve remarkable shrink to T1 level after CRT had favorable outcomes with salvage surgery and could be good candidates for salvage endoscopic treatments. Based on these data, “Japanese Classification of Esophageal Cancer, 12th edition” defined the new endoscopic criteria “remarkable response (RR)”, that means significant volume reduction after treatment, with the subjective endoscopic evaluation are proposed. In addition, the finding of local recurrence (LR) at primary site after achieving a CR was also proposed in the latest edition of Japanese Classification of Esophageal Cancer. The findings of LR are also important for detecting candidates for salvage endoscopic treatments at an early timing during surveillance after CRT. The endoscopic evaluation would encourage us to make concrete decisions for further treatment indications, therefore physicians treating patients with esophageal cancer should be well-acquainted with each finding.

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Authors and Affiliations

  1. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 288-8577, Japan

    Tomonori Yano & Tomohiro Kadota

  2. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yoshito Hayashi

  3. Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan

    Ryu Ishihara & Sachiko Yamamoto

  4. Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan

    Katsunori Iijima

  5. Division of Gastroenterology, Nippon Medical School, Tokyo, Japan

    Katsuhiko Iwakiri

  6. Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan

    Masaya Uesato

  7. Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan

    Tsuneo Oyama

  8. Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Chikatoshi Katada & Manabu Muto

  9. Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan

    Kenro Kawada

  10. Department of Pathology, Shiga University of Medical Science, Otsu, Shiga, Japan

    Ryoji Kushima

  11. Department of Pathology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan

    Yoko Tateishi

  12. Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Satoshi Fujii

  13. Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan

    Noriaki Manabe

  14. Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki City, Nagasaki, Japan

    Hitomi Minami

  15. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Hirofumi Kawakubo

  16. Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan

    Yasuhiro Tsubosa

  17. Clinical Trial Promotion Department, Chiba Cancer Center, Chiba, Japan

    Keiko Minashi

  18. Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Hiroya Takeuchi

  19. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yuichiro Doki

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  1. Tomonori Yano
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  2. Yoshito Hayashi
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Contributions

TY, YH, and MM had the idea for the article. TY and YH performed literature search and data analysis. TY, YH, and MM drafted, and all the other authors critically revised the work.

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Correspondence to Tomonori Yano.

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Yano, T., Hayashi, Y., Ishihara, R. et al. Remarkable response as a new indicator for endoscopic evaluation of local efficacy of non-surgical treatments for esophageal cancer. Esophagus 21, 85–94 (2024). https://doi.org/10.1007/s10388-024-01043-1

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