Multi-institutional analysis of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy: TROD 01-005 study

The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma(CEC)patients who underwent definitive chemoradiotherapy(CRT).The clinical data of 175 biopsyconfirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed.The prognostic factors predicting overall survival(OS),progression-free survival(PFS),and local recurrence-free survival(LRFS)were assessed in uni-and multivariable analyses.The median age of the entire cohort was 56 years(range:26–87 years).All patients received definitive radiotherapy with a median total dose of 60 Gy,and 52%of the patients received cisplatin-based concurrent chemotherapy.The 2-year OS,PFS,and LRFS rates were 58.8%,46.9%,and 52.4%,respectively,with a median follow-up duration of 41.6 months.Patients’performance status,clinical nodal stage,tumor size,and treatment response were significant prognostic factors for OS,PFS,and LRFS in univariate analysis.Non-complete treatment response was an independent predictor for poor OS(HR=4.41,95%CI,2.78–7.00,p<0.001)and PFS(HR=4.28,95%CI,2.79–6.58,p<0.001),whereas poor performance score was a predictor for worse LRFS(HR=1.83,95%CI,1.12–2.98,p=0.02)in multivariable analysis.Fifty-two patients(29.7%)experienced grade II or higher toxicity.In this multicenter study,we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC.Higher radiation doses were found to have no effect on treatment outcomes,but a better response to treatment and a better patient performance status did.

Is increased red cell distribution width an indicating marker of nonalcoholic steatohepatitis and fibrotic stage?

AIM:To evaluate the red cell distribution width(RDW)as an indicator of the presence of non-alcoholic steatohepatitis(NASH)and its association with fibrotic scores.METHODS:A retrospective study was carried out that included sixty-two biopsy proven NASH,32 simple steatosis patients and 30 healthy controls.The correlation between the clinical and histopathological features of NASH patients and RDW values was evaluated.Liver fibrosis scores were measured using a 0 to 4 point scale and were divided in to two groups;fibrosis scores0-1 were termed mild and fibrosis scores 2-4 were termed advanced fibrosis.RDW values were compared between NASH,simple steatosis and healthy controls.Univariate and multivariate analyses were performed to evaluate the independent predicting factors for the presence of liver fibrosis caused by NASH.RESULTS:Patients with NASH had higher RDW values compared with simple steatosis and healthy control groups[14.28%±0.25%vs 13.37%±0.12%,12.96%±0.14%(P<0.01),respectively].Patients with advanced fibrosis had higher RDW values than the mild fibrosis group(15.86%±0.4%vs 13.63%±0.67%,P<0.01,respectively).RDW also correlated with fibrotic scores(r=0.579 andP<0.01).The variables that were significant in the univariate analysis were evaluated in multivariate logistic regression analysis,and RDW was an independent predicting factor of NASH(OR=1.75,95%CI:1.129-2.711,P<0.05).CONCLUSION:RDW a new non-invasive marker that can be used to demonstrate the presence of NASH and indicate advanced fibrotic scores.