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Annals of Surgical Oncology

, Volume 25, Issue 8, pp 2409–2417 | Cite as

The Impact of Pathological Tumor Regression and Nodal Status on Survival and Systemic Disease in Patients Undergoing Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

  • Hiroshi Miyata
  • Koji Tanaka
  • Tomoki Makino
  • Makoto Yamasaki
  • Yasuhiro Miyazaki
  • Tsuyoshi Takahashi
  • Yukinori Kurokawa
  • Kiyokazu Nakajima
  • Shuji Takiguchi
  • Eiichi Morii
  • Masaki Mori
  • Yuichiro Doki
Gastrointestinal Oncology

Abstract

Background

Although tumor regression and nodal status are reported to be useful prognostic factors for patients with oesophageal cancer who are treated with neoadjuvant chemoradiotherapy, the clinical effects of those factors remain to be explained fully in neoadjuvant chemotherapy. Additionally, factor predictive of systemic disease after neoadjuvant therapy remain unexplored.

Methods

The impact of pathological tumor regression and the number of involved lymph nodes on survival and the occurrence of systemic disease were examined in 405 patients with esophageal squamous cell carcinoma who received neoadjuvant chemotherapy,

Results

Among the 405 patients studied, 96 (23.7%) achieved good response, whereas 309 (76.3%) were classified as poor response to neoadjuvant chemotherapy. Systemic disease occurred in 136 patients (34.6%) of 393 patients who underwent curative esophagectomy. The number of involved lymph nodes and pathological tumor regression were associated with survival and the occurrence of systemic disease. Multivariate analysis showed that the number of involved lymph nodes was identified as an independent factor associated with both survival and the occurrence of systemic disease, together with the latest AJCC ypstage. However, tumor regression was not found to be an independent factor associated with survival and systemic disease in multivariate analysis.

Conclusions

Posttreatment nodal status rather than pathological tumor regression seems to be useful for predicting prognosis and the occurrence of systemic disease in patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemotherapy. Additional systemic therapy may be needed in patients with several involved lymph nodes remaining after neoadjuvant therapy.

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Hiroshi Miyata
    • 1
    • 3
  • Koji Tanaka
    • 1
  • Tomoki Makino
    • 1
  • Makoto Yamasaki
    • 1
  • Yasuhiro Miyazaki
    • 1
  • Tsuyoshi Takahashi
    • 1
  • Yukinori Kurokawa
    • 1
  • Kiyokazu Nakajima
    • 1
  • Shuji Takiguchi
    • 1
  • Eiichi Morii
    • 2
  • Masaki Mori
    • 1
  • Yuichiro Doki
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of MedicineOsaka UniversitySuitaJapan
  2. 2.Department of Pathology, Graduate School of MedicineOsaka UniversityOsakaJapan
  3. 3.Department of Digestive SurgeryOsaka International Cancer InstituteOsakaJapan

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