Introduction Consensus management for oesophageal adenocarcinoma is currently neo-adjuvant chemotherapy (NAC) followed by resection. The importance of staging following NAC has become more apparent, and currently staging which occurs post NAC is by CT imaging. We aimed to determine if CT response to NAC predicted survival in patients with oesophageal adenocarcinoma.
Method A retrospective analysis of consecutive patients who underwent oesophageal resection. Clinico-radiological data was identified and pre and post NAC MDT reports were reviewed to assess response to NAC. Patients were grouped into improved, static or deterioration. Survival was calculated for each group and Kaplan-Meier analysis performed.
Results One hundred and sisty nine patients underwent NAC and resection between June 2008 and Jan 2014, with radiological data being available for 150. 65 (43%) patients showed improved CT response, 75 (50%) had static disease and 5 (3%) deterioration. 5 (3%) patients scans were inaccessible. Median survival for the group that showed response was 35 months compared to 30 months for static disease (deterioration group: incalculable). This difference was not statistically significant (p = 0.638). Kaplain-Meier analysis showed a non-significant trend towards increased survival in the response group.
Conclusion In our cohort, CT response to NAC did noes not significantly predict survival in patients with oesophageal carcinoma although a trend is demonstrated. This may be due to oedema round the tumour at time of post NAC scan or tumour replacement with fibrosis which may look similar. With an increasing emphasis on staging post neo-adjuvant chemotherapy, the predictive value of post-NAC functional imaging such as PET needs to be explored.
Disclosure of interest None Declared.
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