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| 1 | Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus显示文摘AIM:To assess tumour regression grade(TRG)and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy.METHODS:Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005and 2011 at a single institution were reviewed.Triplet neoadjuvant chemotherapy consisting of platinum,fluoropyrimidine and anthracycline was considered for operable patients(World Health Organization performance status≤2)with clinical stage T2-4 N0-1.Response to neoadjuvant chemotherapy(NAC)was assessed using TRG,as described by Mandard et al.In addition lymph node downstaging was also assessed.Lymph node downstaging was defined by cN1 at diagnosis:assessed radiologically(computed tomography,positron emission tomography,endoscopic ultrasonography),then pathologically recorded as N0 after surgery;ypN0 if NAC given prior to surgery,or pN0if surgery alone.Patients were followed up for 5 years post surgery.Recurrence was defined radiologically,with or without pathological confirmation.An association was examined between t TRG and lymph node downstaging with disease free survival(DFS)and a comprehensive range of clinicopathological characteristics.RESULTS:Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years(median follow up:2.552,95%CI:2.022-3.081).There was a 1.8%(n=4)inpatient mortality rate.One hundred and thirty-six(62.4%)patients received NAC,with 74.3%(n=101)of patients demonstrating some signs of pathological tumour regression(TRG 1-4)and 5.9%(n=8)having a complete pathological response.Forty four point one percent(n=60)had downstaging of their nodal disease(cN1 to ypN0),compared to only 15.9%(n=13)that underwent surgery alone(pre-operatively overstaged:cN1 to pN0),(P<0.0001).Response to NAC was associated with significantly increased DFS(mean DFS;TRG 1-2:5.1years,95%CI:4.6-5.6 vs TRG 3-5:2.8 years,95%CI:2.2-3.3,P<0.0001).Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC(median DFS;TRG 3-5 and nodal down-staging:5.533 years,95%CI:3.558-7.531 vs TRG 3-5 and no nodal down-staging:1.114 years,95%CI:0.961-1.267,P<0.0001).CONCLUSION:Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS. | Fergus Noble Luke Nolan Adrian C Bateman James P Byrne Jamie J Kelly Ian S Bailey Donna M Sharland Charlotte N Rees Timothy J Iveson Tim J Underwood Andrew R Bateman | 2013 | World Journal of Gastroenterology2013，19，48： | 4 |
| 2 | Perceptual and structural barriers to investing in natural capital: economics from an ecological footprint perspective 显示文摘 | Wackernagel M Rees W E | 1997 | Ecological Economics1997，20，1： | 2 |
| 3 | Guidelines for resection of colorectal cancer liver metastases 显示文摘 | Garden O J Rees M Poston G J | 2006 | Gut2006，55，3： | 1 |
| 4 | Perceptual and structural barriers to investing natural capital:economics from an ecological footprint perspective显示文摘 | Wackernagel M Rees W E | 1997 | Ecological Economic1997，20，1： | 1 |
| 5 | Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding 显示文摘 | Lethaby AE Cooke I Rees M | 2005 | Cochrane Database Syst Rev2005，19，00： | 1 |
| 6 | MHD free and forced convection boundary layer flow along a vertical porous plate显示文摘 | Hossaln M A Alam K C A Rees D A S | 1997 | Appl Mech Engrg1997，2，1： | 1 |
| 7 | Perceptual and structural barriers to investing in natural capital: Economics from an ecological footprint perspective 显示文摘 | Wackernagel M Rees W E | 1997 | Ecological Economics1997，20，3： | 1 |
| 8 | Microemulsion-based media as novel drug delivery systems 显示文摘 | Lawrence M J Rees G D | 2000 | Advanced Drug Delivery Reviews2000，45，1： | 1 |
| 9 | Microemulsion-based media as novel drug delivery systems显示文摘 | LAWRENCE M J REES G D | 2000 | Adv Drug Deliv Rev2000，45，： | 1 |
| 10 | Guidelines for resection ofcolorectal cancer liver metastases 显示文摘 | Garden OJ Rees M Poston GJ | 2006 | Gut2006，553，： | 1 |
| 11 | Monetary analysis:turning a blind eye on sustainability显示文摘 | Rees W E Wackernagel M | 1999 | Ecological Economic1999，29，1： | 1 |
| 12 | Perceplurl and structural barners to in natural capital:economics from an ecological footprint perspective显示文摘 | Wackernagel M Rees W E | 1997 | Ecological Economica1997，20，1： | 1 |
| 13 | Perceptual and structural barriers to investing in natural capital:economics from an ecological footprint perspective显示文摘 | Wackernagel M Rees W E | 1997 | Ecological Economics1997，20，1： | 1 |
| 14 | Perceptual and struc-tural barriers to investing in natural capital:Economicsfrom an ecological footprint perspective显示文摘 | WACKERNAGEL M REES W E | 1997 | Ecological E-conomics1997，，20： | 1 |
| 15 | Filtration increases the correlation between water extractable organic carbon and soil microbial activity显示文摘 | REES R M PARKER J P | 2005 | Soil Biology & Biochemistry2005，37，： | 1 |
| 16 | Allergy, parasites, and the hygiene hypothesis显示文摘 | Yazdanbakhsh M Kremsner PG van Ree R | 2002 | Science2002，19，： | 1 |
| 17 | Ahernative treatments for the menopause 显示文摘 | Rees M | 2009 | Best Pract Res Clin Obstet Gynaecol2009，23，1： | 1 |
| 18 | Cross-sectional study of dentin hypersen- sitivity显示文摘 | Rees JS Addy M | 2002 | Clin Periondontol2002，29，11： | 1 |
| 19 | Maternal protein intake in the pregnant rat programs the insulin axis and body composition in the offspring 显示文摘 | REES W D HAY S M CRUICKSHANK M | 2006 | Metabolism2006，55，5： | 1 |
| 20 | Short-term effects of biochar on soil heavy metal mobility are controlled by intra-particle diffusion and soil pH increase显示文摘 | Rees F Simonnot M O Morel J L | 2014 | European Journal of Soil Science2014，65，1： | 1 |
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