Early and Persistent Dysphagia Relief Predicts Tumor Response in Esophageal Squamous Cell Carcinoma Patients Treated with Immunochemotherapy

作者全名："Huang, Shujie; Tang, Yong; Wu, Hansheng; Shi, Qiuling; Tang, Jiming; Ben, Xiaosong; Zhang, Dongkun; Xie, Liang; Zhou, Haiyu; Chen, Gang; Wang, Sichao; Gao, Zhen; Xie, Zefeng; Chen, Rixin; Qiao, Guibin"

作者地址："[Huang, Shujie; Tang, Yong; Tang, Jiming; Ben, Xiaosong; Zhang, Dongkun; Xie, Liang; Zhou, Haiyu; Chen, Gang; Wang, Sichao; Gao, Zhen; Chen, Rixin; Qiao, Guibin] Southern Med Univ, Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Thorac Surg, Guangzhou, Peoples R China; [Huang, Shujie] Shantou Univ, Med Coll, Shantou, Peoples R China; [Wu, Hansheng; Xie, Zefeng] Shantou Univ, Med Coll, Affiliated Hosp 1, Dept Thorac Surg, Shantou, Peoples R China; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China; [Chen, Rixin] Southern Med Univ, Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Res Ctr Med Sci, Guangzhou, Peoples R China"

通信作者："Chen, RX; Qiao, GB (通讯作者)，Southern Med Univ, Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Thorac Surg, Guangzhou, Peoples R China.; Chen, RX (通讯作者)，Southern Med Univ, Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Res Ctr Med Sci, Guangzhou, Peoples R China."

来源：ANNALS OF SURGICAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000976967700001

JCR分区：Q1

影响因子：3.4

年份：2023

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文献类型：Article; Early Access

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摘要："BackgroundIn this prospective study, we aimed to investigate the role of patient-reported dysphagia relief in predicting pathological tumor responses to neoadjuvant immunochemotherapy (NAIC) in locally advanced esophageal squamous cell carcinoma (ESCC) patients.MethodsThis study was designed as a multi-center, prospective study including ESCC patients who received NAIC in the discovery and validation cohorts. The patients' responses to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-OES 18 and QLQ-C30 were collected at multiple time points. Subsequent time point-intensive esophageal cancer-specific dysphagia trajectories were depicted using growth mixture modeling (GMM) analysis. Furthermore, univariate and multivariate binary logistic regression was used to assess the independent predictors for pathological tumor responses.ResultsA total of 120 patients from the discovery cohort and 42 patients from the validation cohort were included in the analysis. In the discovery cohort, 19 (22.9%) of the 83 patients achieved pCR status. In the independent validation cohort, 24 patients underwent surgery, and 9 (37.5%) patients achieved pCR status. Trajectory analysis showed that, in the pCR group, the beginning of rapid declines in the slope occurred on days 3, 6, and 9. Further multivariate analysis showed that the degree of dysphagia relief (odysphagia%) was the only significant independent predictor for pCR status (OR = 3.267, 95% CI 1.66-6.428, P < 0.001). The AUC value for odysphagia% was 0.961 (95% CI: 0.922-0.999, P < 0.001).ConclusionThe current study demonstrated that a longitudinal patient-reported outcome (PRO) was an easily obtained, cost-effective, and noninvasive tool for predicting tumor responses to neoadjuvant immunochemotherapy."

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