Signet ring cells and conditional survival after trimodality therapy for esophageal adenocarcinoma.

Mitchell, Kyle G; Feldman, Hope; Milton, Denái R; Antonoff, Mara B; Hofstetter, Wayne L; Rice, David C; Vaporciyan, Ara A; Lin, Ruitao; Thall, Peter F; Rajaram, Ravi

Mitchell, Kyle G; Feldman, Hope; Milton, Denái R; Antonoff, Mara B; Hofstetter, Wayne L; Rice, David C; Vaporciyan, Ara A; Lin, Ruitao; Thall, Peter F; Rajaram, Ravi.

Afiliação

Mitchell KG; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Feldman H; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Milton DR; Departmentof Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Antonoff MB; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Hofstetter WL; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Rice DC; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Vaporciyan AA; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Lin R; Departmentof Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Thall PF; Departmentof Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Rajaram R; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

J Surg Oncol ; 2024 Jul 14.

Article em En | MEDLINE | ID: mdl-39004940

ABSTRACT

ABSTRACT

BACKGROUND AND

METHODS:

Although signet ring cell (SRC) histology is associated with resistance to neoadjuvant chemoradiotherapy and worse overall survival (OS) in esophageal adenocarcinoma (EAC), its prognostic relationship among patients who survive the early period following resection is unknown. EAC patients who underwent trimodality therapy at a single institution (2006-2018) were identified. Bayesian multivariable regression (BMR) analyses of OS and additional OS from a 3-year landmark were performed.

RESULTS:

Of 631 patients, SRCs were present in 16.0% (N = 101). SRC was associated with shorter median OS (45.8 [95% confidence interval 31.0-96.7] vs. 79.8 [63.0-107.2] months; p = 0.014). In BMR analysis, the absence of an SRC component was moderately associated with improved OS (probability of beneficial effect, PBE = 0.879). Three-year conditional BMR analysis of additional OS (N = 357) showed that SRC status no longer had a prognostic effect (PBE = 0.546); higher pathological stage was strongly associated with worse additional OS (PBE < 0.001).

CONCLUSIONS:

The presence of SRC portends worse OS following trimodality therapy for EAC. However, this prognostic impact is dynamic and abates by 3 years postoperatively. In contrast, a higher pathological stage is strongly associated with poor overall and 3-year conditional survival.