World Journal of Surgery

, Volume 42, Issue 5, pp 1496–1505 | Cite as

Evaluation of Prognostic Factors for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery

  • Yoichi Hamai
  • Jun Hihara
  • Manabu Emi
  • Takaoki Furukawa
  • Yuji Murakami
  • Ikuno Nishibuchi
  • Yuta Ibuki
  • Ichiko Yamakita
  • Tomoaki Kurokawa
  • Yasushi Nagata
  • Morihito Okada
Original Scientific Report



Intensive trimodality therapy is needed for locally advanced esophageal squamous cell carcinoma (ESCC). However, some patients develop recurrence and die of cancer even after trimodality therapy.


We evaluated prognostic factors based on data from 125 patients with ESCC who underwent neoadjuvant chemoradiotherapy (NCRT) comprising concurrent chemotherapy and 40 Gy of radiation, followed by curative-intent esophagectomy.


Thirty-four (27.2%) patients achieved a pathological complete response (pCR) after NCRT. The 5-year recurrence-free (RFS) and overall survival (OS) rates of all patients were 49.2 and 52.9%, respectively, and were significantly better for patients with pCR than without pCR (p = 0.01 and 0.02, respectively). Univariate and multivariate analyses selected performance status [PS 0 vs. 1: hazard ratio (HR) 2.05; 95% confidence interval (CI) 1.30–4.84; p = 0.01] and ypN (0 vs. 1: HR 2.33; 95% CI 1.12–4.84; p = 0.02; 0 vs. 2/3: HR 3.73; 95% CI 1.68–8.28; p = 0.001) as independent covariates for RFS. Furthermore, PS (0 vs. 1; HR 2.94; 95% CI 1.51–5.72; p = 0.002) and ypN (0 vs. 1; HR 2.26; 95% CI 1.09–4.69; p = 0.03; 0 vs. 2/3: HR 3.90; 95% CI 1.79–8.48; p = 0.001) were also independent covariates for OS.


Performance status 1 and ypN+ were significantly associated with a poor prognosis after trimodality therapy for ESCC.


Compliance with ethical standards

Conflict of interest

The authors have no commercial support or conflicts of interest to disclose.


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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Yoichi Hamai
    • 1
  • Jun Hihara
    • 1
  • Manabu Emi
    • 1
  • Takaoki Furukawa
    • 1
  • Yuji Murakami
    • 2
  • Ikuno Nishibuchi
    • 2
  • Yuta Ibuki
    • 1
  • Ichiko Yamakita
    • 1
  • Tomoaki Kurokawa
    • 1
  • Yasushi Nagata
    • 2
  • Morihito Okada
    • 1
  1. 1.Department of Surgical Oncology, Research Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
  2. 2.Department of Radiation Oncology, Institute of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan

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