Review Article

Understanding Complete Pathologic Response in Oesophageal Cancer: Implications for Management and Survival

Table 1

Tumour response grading systems.

AuthorComplete responseIncomplete responseNo response

Tumor response grading systems that incorporate nodal response and primary site
Meredith et al. [23]Complete response: absence of histological evidence of neoplasia, gross tumor, or individual cells in the resected esophageal specimen by light microscopy but not immunohistochemical stainsPartial response: change in T or N stage from preoperative EUS or greater than 50% reduction in size of tumor compared pre- and postoperativelyNo response: no change in tumor stage compared to preoperative EUS stage and postoperative pathology stage
Donahue et al. [21]Complete response: microscopic absence of any viable tumorNear-complete: microscopic focus of viable tumor cells in an otherwise necrotic specimen with no tumor remaining in resected lymph nodesNo response: macroscopic residual viable tumor at primary site and/or positive lymph nodes
Kim et al. [24]No residual tumorResidual tumor <1 cm in greatest dimension and limited to mucosa or submucosa with no nodal involvement or primary and microscopic neoplastic cells in a single regional nodeNo response: all other tumors

Tumor response grading systems of response at primary site only
Schneider et al. [25]0 vital residual tumor cells at primary site<10% vital residual tumor cells at primary site
10%–50% vital residual tumor cells at primary site
>50% vital residual tumor cells at primary site
Chirieac et al. [20]Complete response: no residual cancer cellsPartial response: 1%–50% residual tumorNo response: more than 50% of tumor remains
Mandard et al. [22]Grade 1: complete regressionGrade 2: isolated cell nests
Grade 3: more residual cancer cells but fibrosis still predominates
Grade 4: residual cancer
Grade 5: absence of regressive changes
Barbour et al. [19]N/AMajor response: <10% residual viable tumor cells>10% residual viable tumor cells
Donington et al. [26]No vital residual tumor cells at primary siteAny residual tumor cells at primary site