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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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

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Authors and Affiliations

  1. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan

    Yoichi Hamai, Jun Hihara, Manabu Emi, Takaoki Furukawa, Yuta Ibuki, Ichiko Yamakita, Tomoaki Kurokawa & Morihito Okada

  2. Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Yuji Murakami, Ikuno Nishibuchi & Yasushi Nagata

Authors
  1. Yoichi Hamai
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  2. Jun Hihara
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  3. Manabu Emi
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  4. Takaoki Furukawa
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  5. Yuji Murakami
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  7. Yuta Ibuki
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  11. Morihito Okada
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Corresponding author

Correspondence to Yoichi Hamai.

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

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Hamai, Y., Hihara, J., Emi, M. et al. Evaluation of Prognostic Factors for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery. World J Surg 42, 1496–1505 (2018). https://doi.org/10.1007/s00268-017-4283-1

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  • DOI: https://doi.org/10.1007/s00268-017-4283-1

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