CT Analysis Predicts Fistula Formation in Esophageal Cancer

The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • 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

  • Esophageal fistulas are one of the most serious complications of advanced esophageal cancer treatment.

  • Clinical factors only moderately predict the risk.

  • Better prediction by CT would give clinicians the opportunity to chose treatments less likely to cause fistulas.

Study Design

  • The investigators analyzed the pretreatment CTs of 54 patients who developed fistulas and 150 who did not.

  • 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

  • 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.

  • 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

  • The sample size was small.

  • The study was retrospective study.

  • CT measurements involved subjective evaluation by radiologists.

Disclosures

  • The work was supported by the Beijing Natural Science Foundation and others.

  • 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 The study has not been peer reviewed.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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