Optimal methods for the prediction of treatment efficacy are seriously lacking in patients with esophageal cancer. However, now, Japanese researchers have found a valuable alternative to existing methods for predicting patient outcomes.
In a study which was published in this month in Annals of Surgery, researchers from Osaka University unveiled that, when compared with primary tumors, which are normally used to assess treatment outcomes in various types of cancers, there is more effective response of lymph nodes to neoadjuvant chemotherapy in predicting disease recurrence & patient survival in individuals with esophageal cancer.
Even though imaging techniques like endoscopy and computed tomography are normally used for the examination of primary tumors in cancer patients, these techniques aren’t helpful to measure primary tumors in the esophagus due to its shape. Therefore, it is hard for physicians to estimate recurrence & survival in patients with esophageal cancer. Attempts were made by the research team to address this issue by finding another indicator of patient outcome.
Lead authors of the research Tomoki Makino and Shinya Urakawa stated that there is a high frequency of lymph node metastases, especially in advanced esophageal cancer as compared with other gastrointestinal cancers. As a result, we reasoned that the response of lymph nodes may be more beneficial than that of primary tumors for predicting patient prognosis and chemotherapeutic efficacy. Therefore, we targeted to determine the clinical utility of lymph node responses to NACT for the prediction of long-term survival in patients with metastatic esophageal cancer.
To achieve this, the researchers employed CT for the measurement of metastatic lymph nodes before & after NACT in individuals with metastatic esophageal cancer. They assessed the chemotherapeutic response by carefully monitoring the respective sizes of primary tumors & all metastatic lymph nodes which met a specific set of criteria.
The researchers found that every lymph node exhibited a different response, even those in the same patient. Therefore, it may be helpful to consider all metastatic lymph nodes for obtaining a precise assessment of the NACT response.