ASO Author Reflections: Evaluation of Tumor Regression After Neoadjuvant Chemoradiotherapy in Esophageal Carcinoma—How to Do It?

Excerpt

Unfortunately, a significant number of curative esophageal carcinomas are in the advanced stage at diagnosis; therefore, most will require neoadjuvant treatment (NAT).1 After completion of the CROSS trial,2 this preoperative chemoradiotherapy regimen became one of the standard treatments for esophageal carcinoma in NAT. Consequently, the evaluation of tumor regression became a hot topic of discussion since it related to long-term prognosis, and even more so if it reached a complete pathological response. The tumor regression grade (TRG) of the primary tumor following neoadjuvant therapy is a worldwide scale and is related to prognostic factors among patients with locally advanced esophageal cancer, although no TRG system has been entirely accepted. Some systems evaluate TRG in esophageal cancer, however none are totally recognized. Some answers are still required, such as gaps between squamous cell carcinoma and adenocarcinoma in esophageal cancer and the effect of the NAT interval and surgery. …