Females Show Better Response to CRT in Esophageal Cancer
TUESDAY, Aug. 22, 2017 -- For patients with locally advanced esophageal carcinoma who received neoadjuvant chemoradiotherapy (nCRT), female sex is associated with increased likelihood of achieving a complete or nearly complete pathologic response, according to a study published online Aug. 22 in the Annals of Thoracic Surgery.
Phillip G. Rowse, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues examined the impact of sex on response to nCRT, tumor recurrence, and survival. One hundred forty-five female patients who received nCRT followed by esophagogastrectomy at three affiliated centers were compared with 221 control male patients.
The researchers found that, compared with men, women were more likely to attain a complete pathologic response or a nearly complete pathologic response to induction therapy (58 versus 47 percent; P = 0.034). Men had a significantly increased risk of recurrence (hazard ratio, 1.80; 95 percent confidence interval, 1.15 to 2.68; P = 0.008). No sex correlation was seen with the risk of death (P = 0.538). A partial responder was three times more likely to have recurrence compared with a complete or nearly complete responder, regardless of sex (hazard ratio, 2.96; 95 percent confidence interval, 1.98 to 4.43; P < 0.001), and was also significantly more likely to die (hazard ratio, 2.56; 95 percent confidence interval, 1.88 to 3.48; P < 0.001).
"Future efforts should be directed at understanding determinants of this sex disparity," the authors write.
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Posted: August 2017