The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.
Key Takeaway
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Quantitative analysis of pretreatment CT scans is strongly predictive of fistula formation in patients with esophageal cancer who receive chemotherapy or chemoradiotherapy.
Why This Matters
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Esophageal fistulas are one of the most serious complications of advanced esophageal cancer treatment.
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Clinical factors only moderately predict the risk.
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Better prediction by CT would give clinicians the opportunity to chose treatments less likely to cause fistulas.
Study Design
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The investigators analyzed the pretreatment CTs of 54 patients who developed fistulas and 150 who did not.
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Researchers measured ulcer depth, tumor thickness and length, and the tumor’s minimum and maximum Hounsfield enhancement units and performed logistic regression to evaluate the associations with fistula formation.
Key Results
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Tumor thickness (odds ratio [OR], 1.17; P = .037), the ratio of ulcer depth to adjacent tumor thickness (OR, 164.95; P < .001), and the ratio of minimum to maximum enhanced CT values (OR, 0.006; P = .039) were independent predictors of fistula formation.
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A model based on those measurements predicted fistula formation with an area under the curve of 0.946 in the testing cohort and 0.841 in the validation cohort.
Limitations
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The sample size was small.
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The study was retrospective study.
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CT measurements involved subjective evaluation by radiologists.
Disclosures
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The work was supported by the Beijing Natural Science Foundation and others.
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The investigators have disclosed no relevant financial relationships.
This is a summary of a preprint research study, “Quantitative CT Analysis to Predict Esophageal Fistula in Patients With Advanced Esophageal Cancer Treated by Chemotherapy or Chemoradiotherapy,” led by Ying-Shi Sun of Peking University Cancer Hospital, China. The study has not been peer reviewed. The full text can be found at researchsquare.com.
M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].
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