Prospective prediction of resistance to neoadjuvant therapy in patients with locoregional esophageal adenocarcinoma

Figures & data

Table 1 Patient demographics

Characteristic	Number of patients	Percentage
Sex
Male	57	89.1
Female	7	10.9
Median age (range), years	59 (40–79)
Histotype
Adenocarcinoma	64	100
Baseline endoscopic ultrasound stage
T stage
TX	3	4.7
T1	2	3.1
T2	13	20.3
T3	45	70.3
T4	1	1.6
N stage
NX	5	7.8
N0	27	42.2
N1	25	39.1
N2	5	7.8
N3	2	3.1
M stage
MX	52	81.3
M0	11	17.2
M1	1	1.6
Neoadjuvant chemotherapy
Yes	64	100
Neoadjuvant radiotherapy
Yes	58	90.6
No	6	9.4
Neoadjuvant chemotherapy regimen
Fluorouracil-based	43	67.2
Non-fluorouracil-based	3	4.7
Unknown	18	28.1
Pathologic tumor regression
exCTRT	22	34.4
Non-exCTRT	42	65.6
Total	64	100

Abbreviation: exCTRT, extreme resistance to neoadjuvant chemoradiotherapy.

Figure 1 Immunohistochemistry staining of nuclear NF-κB (A and D), Gli-1 (B and E), and cytoplasmic staining of SHH (Cand F) in a representative non-exCTRT (A–C) and exCTRT (D–F) patient. Magnification: 40×.

Abbreviation: exCTRT, extreme resistance to chemoradiotherapy.

Table 2 Accuracy of the IHC predictive test

Set	Area under the curve	Accuracy	Specificity (95% CI)	Sensitivity (95% CI)	Positive predictive value (95% CI)	Negative predictive value (95% CI)
Training set (Ν=167)	0.96	90%	90% (89%–94%)	93% (74%–99%)	64% (47%–78%)	98% (94%–l00%)
Validation set (lab1) (Ν=64)	0.96	84%	95% (83%–99%)	64% (4l%–82%)	88% (60%–98%)	83% (69%–92%)
Validation set (lab2) (Ν=64)	0.85	83%	93% (79%–98%)	64% (4l%–82%)	82% (56%–95%)	83% (69%–92%)

Abbreviations: CI, confidence interval; IHC, immunohistochemistry.

Table 3 Concordance between the two pathologic reviewers

		Reviewer#2
		exCTRT	Non-exCTRT
Reviewer#1	exCTRT	16	1
	Non-exCTRT	1	46

Abbreviation: exCTRT, extreme resistance to neoadjuvant chemoradiotherapy.