Evaluating the effect on primary lesions is important in determining treatment strategies for esophageal cancer. The Response Evaluation Criteria in Solid Tumors system, which employs the longest diameter for measuring tumors, is commonly used for evaluating treatment effects. However, the usefulness of these criteria in assessing primary esophageal tumors remains controversial. Thus, we evaluated this issue by measuring not only the longest diameter but also the shorter axis of the tumor. We retrospectively reviewed data from 313 patients with esophageal cancer treated with neoadjuvant chemotherapy followed by esophagectomy at three major high-volume centers in Japan. All patients underwent contrast-enhanced computed tomography before and after chemotherapy. The longest and shortest tumor diameters were measured in each case. Treatment effects were adapted to the Response Evaluation Criteria in Solid Tumors system. Correlations between pathological and survival data were also analyzed. Inter-observer discrepancies were examined for changes in the longest diameter and shorter axis of the tumor (the intraclass correlation coefficients were 0.550 and 0.624, respectively). The shorter axis was correlated with the pathological response in the multivariate analysis (p < 0.001). The shorter axis was significantly associated with overall survival and disease-free survival (both p < 0.001), whereas this association was not observed for the longest tumor diameter. This multicenter study demonstrated that the Response Evaluation Criteria in Solid Tumors system is useful for predicting pathological response and survival by incorporating the shorter axis of the primary esophageal tumor.

中文翻译：

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使用具有较短轴测量值的 RECIST 系统评估食管癌新辅助化疗的效果：一项回顾性多中心研究

评估对原发病变的影响对于确定食管癌的治疗策略很重要。实体瘤系统中的反应评估标准采用最长直径来测量肿瘤，通常用于评估治疗效果。然而，这些标准在评估原发性食管肿瘤方面的有效性仍存在争议。因此，我们通过测量肿瘤的最长直径和较短的轴来评估这个问题。我们回顾性地审查了在日本三个主要高容量中心接受新辅助化疗继以食管切除术治疗的 313 名食管癌患者的数据。所有患者在化疗前后均接受了对比增强计算机断层扫描。在每种情况下测量最长和最短的肿瘤直径。治疗效果适应实体瘤系统中的反应评估标准。还分析了病理和存活数据之间的相关性。检查观察者间差异的肿瘤最长直径和较短轴的变化（组内相关系数分别为 0.550 和 0.624）。较短的轴与多变量分析中的病理反应相关（p < 0.001）。较短的轴与总生存期和无病生存期显着相关（均 p < 0.001），而对于最长的肿瘤直径则未观察到这种关联。