Nav: Home

Mapping residual esophageal tumors -- a glimpse into the future?

January 10, 2019

Osaka, Japan - It's one of the first questions asked by many newly-diagnosed cancer patients--"What are my chances of beating this?" Often there is no clear answer, with survival rates differing widely depending on the cancer stage and available treatment options. However, post-operative testing that provides an accurate prediction of long-term treatment outcomes is the next best thing to a crystal ball, allowing clinicians to plan further treatment or follow-up strategies and more accurately inform patients about their prognoses.

But is this possible? Researchers in Japan think that it might be, at least for esophageal cancer patients. In a recent study published in Annals of Surgery, a team led by researchers at Osaka University retrospectively examined tissue specimens from 120 esophageal cancer patients following treatment, allowing them to both assess tumor characteristics and investigate how these related to long-term treatment outcomes.

Esophageal cancer is the sixth most common cause of cancer-related death worldwide and, despite various treatment options, has a poor long-term prognosis. Most locally-advanced esophageal cancers are treated with neoadjuvant chemotherapy (NAC), which aims to increase the likelihood of successful curative surgery by reducing tumor size and eradicating systemic micro-metastases. Tissue specimens are usually examined after surgery to assess how a tumor has responded to chemotherapy treatment. However, standard methods do not map the remaining tumor cells to the different layers of the esophageal wall, and therefore provide an incomplete picture of treatment outcome.

The team hypothesized that there might be specific patterns of residual tumors after NAC, and that they might have different clinical implications for patients

The researchers therefore mapped the exact locations of residual tumors in the esophageal wall of patients after NAC and assessed whether tumor location was associated with clinicopathological parameters including specific oncological outcomes.

After NAC, they identified four tumor remnant patterns that are clearly different from those reported previously; the most common residual tumor pattern was a 'shallow type.' However, in approximately 40% of cases, tumor cells unexpectedly disappeared in the superficial (mucosal) layer of the esophageal wall, indicating that it would be difficult to diagnose whether or not tumor cells completely disappeared after NAC based only on an endoscopic mucosal biopsy. When the team examined associations between these patterns and disease factors, including prognosis, they found that pattern types 3 and 4 had higher risks of pleural dissemination and distant metastases than types 1 or 2. These results shows that patients displaying patterns 3 or 4 should have more regular follow-up appointments than those with pattern types 1 or 2. Interestingly, survival was similar among the four groups.

According to lead authors Tadayoshi Hashimoto and Tomoki Makino, these findings have significant clinical implications. They explained that by determining the tumor remnant pattern from resected specimens and post-operative image examination, a personalized treatment plan for each patient can be developed. This customized approach is expected to significantly improve esophageal cancer treatment outcomes.
-end-
The article, "The pattern of residual tumor after neoadjuvant chemotherapy for locally advanced esophageal cancer and its clinical significance", was published in Annals of Surgery at doi: https://doi.org/10.1097/SLA.0000000000003129.

About Osaka University

Osaka University was founded in 1931 as one of the seven imperial universities of Japan and now has expanded to one of Japan's leading comprehensive universities. The University has now embarked on open research revolution from a position as Japan's most innovative university and among the most innovative institutions in the world according to Reuters 2015 Top 100 Innovative Universities and the Nature Index Innovation 2017. The university's ability to innovate from the stage of fundamental research through the creation of useful technology with economic impact stems from its broad disciplinary spectrum.

Website: https://resou.osaka-u.ac.jp/en/top

Osaka University

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
More Cancer News and Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#535 Superior
Apologies for the delay getting this week's episode out! A technical glitch slowed us down, but all is once again well. This week, we look at the often troubling intertwining of science and race: its long history, its ability to persist even during periods of disrepute, and the current forms it takes as it resurfaces, leveraging the internet and nationalism to buoy itself. We speak with Angela Saini, independent journalist and author of the new book "Superior: The Return of Race Science", about where race science went and how it's coming back.