The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.
Key Takeaway
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Quantitative analysis of pretreatment CT scans is strongly predictive of fistula formation in patients with esophageal cancer who receive chemotherapy or chemoradiotherapy.
Why This Matters
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Esophageal fistulas are one of the most serious complications of advanced esophageal cancer treatment.
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Clinical factors only moderately predict the risk.
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Better prediction by CT would give clinicians the opportunity to chose treatments less likely to cause fistulas.
Study Design
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The investigators analyzed the pretreatment CTs of 54 patients who developed fistulas and 150 who did not.
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Researchers measured ulcer depth, tumor thickness and length, benadryl good spider bites and the tumor’s minimum and maximum Hounsfield enhancement units and performed logistic regression to evaluate the associations with fistula formation.
Key Results
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Tumor thickness (odds ratio [OR], 1.17; P = .037), the ratio of ulcer depth to adjacent tumor thickness (OR, 164.95; P < .001), and the ratio of minimum to maximum enhanced CT values (OR, 0.006; P = .039) were independent predictors of fistula formation.
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A model based on those measurements predicted fistula formation with an area under the curve of 0.946 in the testing cohort and 0.841 in the validation cohort.
Limitations
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The sample size was small.
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The study was retrospective study.
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CT measurements involved subjective evaluation by radiologists.
Disclosures
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The work was supported by the Beijing Natural Science Foundation and others.
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The investigators have disclosed no relevant financial relationships.
This is a summary of a preprint research study, “Quantitative CT Analysis to Predict Esophageal Fistula in Patients With Advanced Esophageal Cancer Treated by Chemotherapy or Chemoradiotherapy,” led by Ying-Shi Sun of Peking University Cancer Hospital, China. The study has not been peer reviewed. The full text can be found at researchsquare.com.
M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].
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