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Neoadjuvant Chemotherapy or Adjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 10 December 2023

This article has been updated

Abstract

Background

Chemotherapy and chemoradiation have become essential adjuncts to improve the survival of patients with resectable esophageal squamous cell carcinoma (ESCC) in the perioperative period. Although preoperative treatment plus surgery is commonly used, controversy remains regarding the optimal treatment strategy for patients with locally advanced ESCC.

Methods

A retrospective review of clinical stage II and III ESCC patients who underwent esophagectomy at Henan Cancer Hospital between October 2014 and October 2017 was performed. The patients were divided into a neoadjuvant chemotherapy (NAC) group and an adjuvant chemotherapy (AC) group. Propensity score matching (PSM) was used to exclude confounders. Survival was estimated using Kaplan‒Meier analysis and compared by the log-rank test. The Cox proportional hazards regression model was used for both the univariate and multivariate analyses.

Results

A total of 684 patients were enrolled, including 365 (53.4%) patients in the NAC group. After PSM, 294 pairs of patients were left. NAC prolonged the OS (not reached versus 57.3 months, P = 0.002) and DFS (57.2 vs. 36.4 months, P = 0.010) and decreased the total rate of recurrence (50.1% vs. 59.2%, P = 0.025) and local recurrence (27.9% vs. 36.7%, P = 0.022) compared with AC. The multivariable analyses showed that NAC plus surgery modality was an independent predictor for improved OS (HR: 0.582, 95% CI: 0.467-0.786, P = 0.001).

Conclusion

NAC plus surgery prolonged OS and DFS, and significantly decreased the total rate of recurrence compared with surgery plus AC in patients with clinical stage II and III ESCC.

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Acknowledgment

Funding: This study was funded by the Province-Ministry Co-construction Project of Health Committee of Henan Province (SB201901108), Talent Youth Project of Henan Youth Health Science and Technology Innovation Foundation (YXKC2020022) and Henan Province Key Project of Science and Technology (222102310170). Thanks to all participators in this study and thanks to all clinicians for their tremendous work in this study.

Funding

This study was funded by the Province-Ministry Co-construction Project of Health Committee of Henan Province (SB201901108), Talent Youth Project of Henan Youth Health Science and Technology Innovation Foundation (YXKC2020022) and Henan Province Key Project of Science and Technology (222102310170).

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Author notes

  1. Hai-Bo Sun and Sen Yan have authors contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China

    Hai-Bo Sun MD, Sen Yan MD, Xian-Ben Liu MD, Wen-Qun Xing MD, Pei-Nan Chen MD, Shi-Lei Liu MD, Peng Li MD, Ya-Xing Ma MD & Duo Jiang MD

  2. Department of Thoracic Surgery, Leuven University, Leuven, Belgium

    Toni Lerut MD

  3. Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria Main University Hospital, Alexandria University, Alexandria, Egypt

    Ahmed Daoud MD

Authors
  1. Hai-Bo Sun MD
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  2. Sen Yan MD
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Correspondence to Hai-Bo Sun MD.

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The original online version of this article was revised: Hai‑Bo Sun was listed twice in the author group. This was corrected.

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Sun, HB., Yan, S., Liu, XB. et al. Neoadjuvant Chemotherapy or Adjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 31, 2443–2450 (2024). https://doi.org/10.1245/s10434-023-14581-2

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