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Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis

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Abstract

Background

Neoadjuvant chemotherapy (NAC) with CF (cisplatin/5-FU) was demonstrated to improve survival of clinical stage II/III (cStage II/III) esophageal squamous cell carcinoma (ESCC), however prognostic outcome remains unsatisfactory. We have recently reported preliminary potentiality of short-term survival benefit by NAC with DCF (docetaxel/cisplatin/5-FU).

Patients and methods

Thirty-eight ESCC patients who underwent DCF NAC between 2009 and 2012 were investigated for prognosis with a median follow-up period of 49 months as compared to those with CF NAC.

Results

(1) ESCC patients with DCF NAC showed 66 % of 3-year progression-free survival (PFS), which is significantly superior to that of CF NAC (38 %) (p = 0.018). ESCC patients with DCF NAC showed 79 % of 3-year overall survival (OS), which is marginally significantly superior to that of CF NAC (65 %) (p = 0.093). (2) The multivariate Cox proportional hazards model revealed that DCF NAC was an independent prognostic factor for PFS (p = 0.0013) and OS (p = 0.047), respectively, when adjusted for patient sex, age, cT, cN, and preoperative borderline resectability. (3) Patients with more advanced stage were rather frequently included in DCF NAC than in CF NAC, however there was no significant difference. Nevertheless, propensity score (PS) to predict DCF NAC was significantly higher than CF NAC (p = 0.019). (4) Both NAC and PS were again applied to the multivariate Cox proportional hazards model, and DCF NAC was the only remnant prognostic indicator for PFS (p = 0.0044) and OS (p = 0.063).

Conclusion

Prognosis may be significantly improved in cStage II/III ESCC patients who underwent DCF NAC than those with CF NAC.

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Authors and Affiliations

  1. Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Keishi Yamashita, Natsuya Katada, Hiromitsu Moriya, Kei Hosoda, Hiroaki Mieno & Masahiko Watanabe

  2. Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan

    Chikatoshi Katada & Wasaburo Koizumi

  3. Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Japan

    Keika Hoshi

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  1. Keishi Yamashita
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  2. Natsuya Katada
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  3. Hiromitsu Moriya
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  4. Kei Hosoda
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Correspondence to Keishi Yamashita.

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11748_2016_626_MOESM1_ESM.pptx

Fig. S1 PFS of cStage II/III ESCC according to various clinical factors. (a) Sex, (b) Age, (c) cT, (d) borderline resectability, and (e) cN (PPTX 70 kb)

11748_2016_626_MOESM2_ESM.pptx

Fig. S2 OS of cStage II/III ESCC according to various clinical factors. (a) Sex, (b) Age, (c) cT, (d) borderline resectability, and (e) cN (PPTX 70 kb)

Fig. S3 Prognosis of cStage II/III ESCC according to NAC after adjusting PS. (a) PFS, and (b) OS (PPTX 44 kb)

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Yamashita, K., Katada, N., Moriya, H. et al. Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis. Gen Thorac Cardiovasc Surg 64, 209–215 (2016). https://doi.org/10.1007/s11748-016-0626-3

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  • DOI: https://doi.org/10.1007/s11748-016-0626-3

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