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Florid Foreign Body-type Giant Cell Response to Keratin Is Associated With Improved Overall Survival in Patients Receiving Preoperative Therapy for Esophageal Squamous Cell Carcinoma

Publication ,  Journal Article
Chen, W; Zhao, L; Agoston, A; White, A; Mazzola, E; Boyle, PJ; Deshpande, V; Hornick, JL; Bueno, R; Bass, AJ; Enzinger, P; Mamon, H ...
Published in: American Journal of Surgical Pathology
December 2021

While most resection specimens from patients with neoadjuvantly treated esophageal squamous cell carcinoma show therapy-related changes in the form of inflammation and fibrosis, others harbor a florid foreign body-type giant cell response to keratin debris. The purpose of our study was to perform a detailed clinicopathologic analysis of these histologic types of treatment responses and correlate these findings with patient outcome. Clinical and pathologic parameters from 110 esophagogastrectomies were recorded and analyzed. Two main types of histologic responses were observed: inflammatory-predominant response (59%) and florid foreign body-type giant cell response to keratin (41%). Irrespective of cG, cTNM, and amount of residual cancer, florid foreign body-type giant cell reaction was predominantly noted deep within the esophageal wall, while the inflammatory response was restricted to the mucosa, submucosa, and inner half of muscularis propria. Patients with foreign body-type giant cell response showed significantly better overall survival compared with the inflammatory response group (log-rank test =0.015). Florid foreign body-type giant cell response was the only factor associated with improved survival in a multivariable analysis for overall survival (hazard ratio=0.5; 95% confidence interval=0.3-1.0; =0.038), but not in the model for disease-specific survival, whereas ypTNM stage II was the only significant risk factor for disease-specific survival in multivariable analysis (hazard ratio=3.4; 95% confidence interval=1.0-11.2; =0.047). Our results suggest that in addition to the College of American Pathologists Tumor Regression Score and ypTNM stage, subtype of histologic response to therapy may represent another prognostic marker for neoadjuvantly treated esophageal squamous cell carcinoma.

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Published In

American Journal of Surgical Pathology

DOI

ISSN

0147-5185

Publication Date

December 2021

Volume

45

Issue

12

Start / End Page

1648 / 1660

Publisher

Ovid Technologies (Wolters Kluwer Health)

Related Subject Headings

  • Pathology
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Chen, W., Zhao, L., Agoston, A., White, A., Mazzola, E., Boyle, P. J., … Patil, D. T. (2021). Florid Foreign Body-type Giant Cell Response to Keratin Is Associated With Improved Overall Survival in Patients Receiving Preoperative Therapy for Esophageal Squamous Cell Carcinoma. American Journal of Surgical Pathology, 45(12), 1648–1660. https://doi.org/10.1097/pas.0000000000001797
Chen, Wei, Lei Zhao, Agoston Agoston, Abby White, Emanuele Mazzola, Patrick J. Boyle, Vikram Deshpande, et al. “Florid Foreign Body-type Giant Cell Response to Keratin Is Associated With Improved Overall Survival in Patients Receiving Preoperative Therapy for Esophageal Squamous Cell Carcinoma.” American Journal of Surgical Pathology 45, no. 12 (December 2021): 1648–60. https://doi.org/10.1097/pas.0000000000001797.
Chen W, Zhao L, Agoston A, White A, Mazzola E, Boyle PJ, et al. Florid Foreign Body-type Giant Cell Response to Keratin Is Associated With Improved Overall Survival in Patients Receiving Preoperative Therapy for Esophageal Squamous Cell Carcinoma. American Journal of Surgical Pathology. 2021 Dec;45(12):1648–60.
Chen, Wei, et al. “Florid Foreign Body-type Giant Cell Response to Keratin Is Associated With Improved Overall Survival in Patients Receiving Preoperative Therapy for Esophageal Squamous Cell Carcinoma.” American Journal of Surgical Pathology, vol. 45, no. 12, Ovid Technologies (Wolters Kluwer Health), Dec. 2021, pp. 1648–60. Crossref, doi:10.1097/pas.0000000000001797.
Chen W, Zhao L, Agoston A, White A, Mazzola E, Boyle PJ, Deshpande V, Hornick JL, Bueno R, Bass AJ, Enzinger P, Mamon H, Redston M, Patil DT. Florid Foreign Body-type Giant Cell Response to Keratin Is Associated With Improved Overall Survival in Patients Receiving Preoperative Therapy for Esophageal Squamous Cell Carcinoma. American Journal of Surgical Pathology. Ovid Technologies (Wolters Kluwer Health); 2021 Dec;45(12):1648–1660.

Published In

American Journal of Surgical Pathology

DOI

ISSN

0147-5185

Publication Date

December 2021

Volume

45

Issue

12

Start / End Page

1648 / 1660

Publisher

Ovid Technologies (Wolters Kluwer Health)

Related Subject Headings

  • Pathology
  • 1103 Clinical Sciences