USING ENDOSONOGRAPHY TO ASSESS THE EFFECTS OF NEOADJUVANT THERAPY IN PATIENTS WITH ADVANCED ESOPHAGEAL CANCER

OBJECTIVE. The aim of this study was to determine the usefulness of en dosonography for evaluating the effect of neoadjuvant therapy for adva nced esophageal carcinoma. MATERIALS AND METHODS. Thirty-four patients with esophageal carcinoma (stage II, 16 patients; stage III, 18 patie nts) underwent various preoperative treatments. In all patients, endos onography was performed before and after treatment, and the percentage reduction in tumor size was calculated from the maximum area of the t umor. In the 27 patients who underwent surgery, the percentage reducti on was compared with the pathologic response. Also, the overall surviv al rates were compared with the percentage reduction in tumor area. RE SULTS. Reduction in tumor area ranged from 0% to 47%, The patients wer e divided into three groups according to the percentage reduction in t umor area. Pathologic response was graded according to the number of v iable cells in the entire lesion. Correlation between pathologic respo nse and percentage reduction in tumor area was strong, We found a sign ificant difference in survival rates among the three groups. CONCLUSIO N. The percentage reduction in tumor area estimated by means of endoso nography reflects the histologic effectiveness of neoadjuvant therapy in patients with advanced esophageal carcinoma and may enable clinicia ns to predict the prognosis of the disease.