Novel calculator may inform treatment decisions for esophageal adenocarcinoma patients

A group of researchers from Roswell Park Cancer Institute (NY, USA) have developed a novel calculator that could help more easily identify which esophageal adenocarcinoma patients will derive benefit from neoadjuvant chemoradiation. The study was published recently in the Journal of American College of Surgeons.

The researcher’s utilized the National Cancer Data Base to obtain clinical data for 8974 patients diagnosed with early-stage esophageal cancer 2006-2012. To develop the calculator the team evaluated characteristics such as the patient’s tumor grade, comorbidity score and neoadjuvant chemoradiation status.

Utilizing the calculator, the researchers demonstrated that patients whose tumors has metastasized to nearby lymph nodes, older patients and those with more aggressive cancers benefit most from neoadjuvant chemoradiation.

Lead author Emmanuel Gabriel from Roswell Park Cancer Institute commented: “The use of calculators to estimate outcomes is becoming increasingly common, and is being applied to real-time clinical situations to aid in treatment decision-making and individualizing therapy.”

The researchers believe their calculator could assist physicians and patients with treatment decision-making but acknowledge that the tool needs to be validated prospectively before the extent of its clinical application is decided.

Senior author of the study Moshim Kukar (Roswell Park Cancer Institute) explained: “Our effort is a good example of how you can use large national databases to create calculators to guide and improve preoperative decision-making. Such tools can help us, for example, to avoid the toxic side effects of upfront chemoradiotherapy in a subset of patients. However, our calculator should be validated prospectively before firm conclusions can be drawn about its value in treatment selection.”

Sources: Gabriel E, Attwood K, Shah R, Nurkin S, Hochwald S, Kukar M. Novel calculator to estimate overall survival benefit from neoadjuvant chemoradiation in patients with esophageal adenocarcinoma. J. Am. Coll. Surg DOI: 10.1016/j.jamcollsurg.2017.01.043 (2017); Roswell Park Cancer Institute press release via Science Daily