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Br J Cancer. 2019 Nov 6. doi: 10.1038/s41416-019-0623-2. [Epub ahead of print]

Post-neoadjuvant cellular dissociation grading based on tumour budding and cell nest size is associated with therapy response and survival in oesophageal squamous cell carcinoma.

Author information

1
Institute of Pathology, Technical University Munich, Munich, Germany.
2
German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
3
German Cancer Consortium (DKTK), Partner Site Munich, Institute for Translational Cancer Research, Munich, Germany.
4
Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
5
Department of Radiation Therapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
6
II Medizinische Klinik, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
7
Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
8
Institute of Innovative Radiotherapy (iRT), Helmholtz Center Munich, Munich, Germany.
9
Institute of Pathology, Technical University Munich, Munich, Germany. wilko.weichert@tum.de.
10
German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany. wilko.weichert@tum.de.

Abstract

BACKGROUND:

Cellular Dissociation Grade (CDG) composed of tumour budding and cell nest size has been shown to independently predict prognosis in pre-therapeutic biopsies and primary resections of oesophageal squamous cell carcinoma (ESCC). Here, we aimed to evaluate the prognostic impact of CDG in ESCC after neoadjuvant therapy.

METHODS:

We evaluated cell nest size and tumour budding activity in 122 post-neoadjuvant ESCC resections, correlated the results with tumour regression groups and patient survival and compared the results with data from primary resected cases as well as pre-therapeutic biopsies.

RESULTS:

CDG remained stable when results from pre-therapeutic biopsies and post-therapeutic resections from the same patient were compared. CDG was associated with therapy response and a strong predictor of overall, disease-specific (DSS) and disease-free (DFS) survival in univariate analysis and-besides metastasis-remained the only significant survival predictor for DSS and DFS in multivariate analysis. Multivariate DFS hazard ratios reached 3.3 for CDG-G2 and 4.9 for CDG-G3 neoplasms compared with CDG-G1 carcinomas (p = 0.016).

CONCLUSIONS:

CDG is the only morphology-based grading algorithm published to date, which in concert with regression grading, is able to contribute relevant prognostic information in the post-neoadjuvant setting of ESCC.

PMID:
31690830
DOI:
10.1038/s41416-019-0623-2

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