ArticleAnnals of surgical oncology2026
Accuracy of Predicting Residual Disease and Disease Progression During Active Surveillance for Esophageal Cancer.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and Safety of Conversion Surgery Versus Non-Surgical Treatment for Initially Unresectable Esophageal Cancer: A Systematic Review and Meta-Analysis.Journal of gastrointestinal cancer · 2026Pooled it
- Surveillance vs Standard Surgery and Cost-Effectiveness After Neoadjuvant Chemoradiotherapy for Esophageal Cancer: Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2026Trial
- Comparison of the Cox Proportional Hazards Model and Random Survival Forest Algorithm for Predicting Patient-Specific Survival Probabilities in Clinical Trial Data.Biometrical journal. Biometrische Zeitschrift · 2026Article
- Article
- Predictors and Patterns of Recurrence After a Watchful Waiting Approach following Clinical Complete Response to Neoadjuvant Radiochemotherapy for Esophageal Cancer.Current oncology (Toronto, Ont.) · 2026Article
- Article
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
backgroundTo date, active surveillance has been non-inferior to standard surgery for patients with esophageal cancer, achieving a clinical complete response (CCR) after neoadjuvant chemoradiotherapy (nCRT). However, two thirds of patients have residual disease detected 12 weeks after nCRT and undergo surgery. At 12 weeks, nearly half of the patients with CCR will experience locoregional regrowth. This study aimed to identify routine predictive factors for achieving (sustained) CCR to improve patient selection for active surveillance.
methodsData from the SANO trial were analyzed, including data of patients who underwent nCRT for esophageal cancer. Logistic regression assessed predictors of CCR at 12 weeks, with potential factors including age, sex, WHO performance status, clinical T and N categories, histology, differentiation grade, tumor location, and tumor length. For patients with CCR in active surveillance, cause-specific proportional hazards regression identified predictors of sustained CCR (no locoregional regrowth, dissemination, or death) during a minimum 3-year follow-up period. Discrimination was quantified using the concordance statistic (c-statistic) with bootstrap validation.
resultsOf 750 patients, 274 (37 %) achieved CCR at 12 weeks. Higher cN category was associated with lower likelihood of CCR (cN2-3 vs cN0: odds ratio [OR], 0.57; 95 % confidence interval [CI], 0.37-0.88; P < 0.01; c-statistic, 0.56). Among 198 patients in active surveillance, 25 % had sustained CCR after a median follow-up period of 54 months (interquartile range [IQR],46-58 months). Higher cN category (cN2-3 vs cN0; HR, 2.08; 95 % CI, 1.25-3.48; P < 0.01) was associated with non-sustained CCR (c-statistic, 0.58).
conclusionStandard clinical parameters poorly predict clinical response after nCRT. Additional predictive parameters and better diagnostic tests are needed to improve patient selection for active surveillance.
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