Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus

Table 3 Clinical and pathological characteristics of the 136 patients treated with neoadjuvant chemotherapy for esophageal and gastro-esophageal adenocarcinoma, classified as responders Tumour regression grade 1-2 or non-reponders tumour regression grade 3-5 n (%)

		TRG 1-2 36 (26.5)	TRG 3-5 100 (73.5)	Pvalue
Preoperative status
Age (range) yr1		65.27 (26.99-76.04)	63.51 (32.77-81.28)	0.410
Sex ratio (M:F)1		32 (88.9):4 (11.1)	86 (86):14 (14)	0.662
cT stage	1	0 (0)	0 (0)	0.396
	2	2 (5.6)	14 (14)
	3	33 (91.7)	81 (81)
	4	1 (2.8)	5 (5)
cN stage	0	5 (13.9)	14 (14)	0.987
	1	31 (86.1)	86 (86)
cM stage	0	35 (97.1)	99 (99)	0.456
	1	1 (2.8)	1 (1)
Performance status	0	12 (33.3)	23 (23)	0.225
	1	23 (63.9)	73 (73)
	2	1 (2.8)	4 (4.0)
ASA	1	2 (5.6)	9 (9.1)	0.408
	2	32 (88.9)	74 (74.7)
	3	2 (5.6)	16 (16.2)
O-POSSUM		15 (12-23)	16 (12-26)	0.476
Tumour site	Middle 1/3	1 (2.8)	0 (0)	0.738
	Lower 1/3	15 (41.7)	42 (42)
	GEJ-S1	7 (19.4)	16 (16)
	GEJ-S2	9 (25)	25 (25)
	GEJ-S3	4 (11.1)	16 (16)
Operative outcomes
Length of operation (min)1		262 (163-427)	260 (120-471)	0.513
Blood loss (mL)1		300 (0-3000)	325 (0-1700)	0.673
Clavien Dindo Max	0	14 (38.9)	39 (39.4)	0.531
	1	2 (5.6)	6 (6.1)
	2	14 (38.9)	26 (26.3)
	3	4 (11.1)	13 (13.1)
	4	2 (5.6)	15 (15.2)
	5	0 (0)	0 (0)
Anastomotic leaks		1 (2.8)	8 (8.1)	0.276
Pathological outcomes
yPT	0	8 (22.2)	0 (0)	< 0.0001
	1	11 (30.6)	12 (12)
	2	9 (25)	25 (25)
	3	8 (22.2)	58 (58)
	4	0 (0)	5 (5)
yPN	0	34 (94.4)	39 (39)	< 0.0001
	1	0 (0)	21 (21)
	2	2 (5.6)	23 (23)
	3	0 (0)	17 (17)
yPM	0	36 (100)	100 (100)	0.579
Nodal downstaged (cN1 to ypN0)		30 (83.3)	30 (30)	< 0.0001
Positive nodes1		0 (0-5)	1 (0-24)	< 0.0001
Nodal yield1		18 (4-25)	18 (3-53)	0.984
Resection clearance	R0	35 (97.2)	75 (75)	0.004
Vascular invasion		4 (11.1)	37 (37)	0.004
Lymphatic invasion		4 (11.1)	18 (18)	0.338
Perineural invasion		2 (5.6)	18 (18)	0.072
Maximum tumour diameter1	(mm)	15 (0-110)	30 (0-155)	< 0.0001
Morphology	Ulcer	30 (93.8)	66 (68)	0.003
	Polypoid	2 (6.3)	21 (21.6)
	Fungating	0 (0)	3 (3.1)
	Diffuse infiltrating	0 (0)	7 (7.2)
Grade	G1	8 (22.2)	8 (8)	0.104
	G2	9 (25)	28 (28)
	G3	19 (52.8)	63 (63)
	G4	0 (0)	1 (1)
Sites of recurrence	Local	0 (0)	8 (8.1)	0.080
	Nodal	1 (2.8)	13 (13.1)	0.082
	Distant	2 (5.6)	42 (42.4)	< 0.0001

Values in parentheses are percentages unless indicated.

¹Values in parentheses are range. TRG: Tumour Regression Grade; ASA:American Society of Anesthesiologists classification; O-POSSUM: Oesophagogastric surgery-physiological and operative severity score for the enumeration of mortality and morbidity; GEJ-S1-3: Gastro-esophageal junction-Siewert type 1-3.