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Endoscopic assessment of the effect of the pre operative combined therapy in the esophageal cancer

Endoscopic assessment of the effect of the pre operative combined therapy in the esophageal cancer

Gastroenterological Endoscopy 27(3): 303-315

The effect of pre-operative combined therapy with radiation as its main component was evaluated by surgical specimen in 173 [human] cases of esophageal cancer from 1969-1982. The main points of the present investigation were: establishment of criteria to judge the effects of combined therapy; correlation between the histological features and the criteria established; and evaluation of the predictive effects of the combined therapy through endoscopical findings. According to the judgment criteria, the effect was classified in 4 types: complete response, partial response, minor improvement and no improvement. A significant correlation was found between the histological features and the reestablished criteria. Taking into account the changes of the endoscopic findings due to combined therapy, the most appropriate time to judge its effects was between 2 or 3 days before the operation. In order to estimate the predictable effect of the pre-operative combined therapy the 3 following items related to the main tumor were considered: the configuration of the elevation; the exposure of the cancerous region after using lugol solution; and the configuration of the oral side of the tumor. The 1st 2 items were subdivided in 4 types, and the 3rd one in 3 types. For each case, the sum of the above mentioned items was used as the index of evaluation of the effect. According to the pre-operative combined therapy which was used, the indices found for effects EF1 [endoscopic effect] EF2 and EF3 were: -0.180 .+-. 0.303, -0.010 .+-. 0.291 and 0.183 .+-. 0.142, respectively. A good correlation was found between this index of evaluation and the recent clinical cases.

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Accession: 005359115

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