Morphomic factors associated with complete response to neoadjuvant therapy in esophageal carcinoma

Abstract Background In patients undergoing neoadjuvant chemoradiotherapy (nCRT) followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC), patients with a pathological complete response (pCR) have the greatest benefit. The purpose of this study was to identify morphomic factors obtained from pre-treatment computed tomography scans associated with a pathological complete response in ESCC. Methods We retrospectively analyzed patients with ESCC treated with nCRT who underwent esophagectomy between 2006 and 2016. Clinical and morphomic characteristics pre-nCRT were analyzed to identify factors associated with pCR using univariate and multivariable analyses. Results There were 183 patients with ESCC included in this study, and 45 patients (24.6%) achieved pCR. The overall survival in patients with pCR was better than patients without pCR (5.8 vs 1.2 years, p Conclusions Increased age, radiation dose≧4000 cGy, and larger dorsal muscle group normal-density area were significantly associated with pCR. These factors may be useful in determining which patients are most likely to benefit from nCRT followed by esophagectomy.