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Neoadjuvant Chemotherapy Improves Feasibility of Larynx Preservation and Prognosis in Resectable Locally Advanced Cervical Esophageal Cancer

  • Thoracic Oncology
  • Published:
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Abstract

Background

The optimal strategy for cervical advanced esophageal cancer remains controversial in terms of oncologic outcome as well as vocal and swallowing function. Recently, in East Asian countries, neoadjuvant chemotherapy (NAC) has been a standard strategy for advanced esophageal cancer.

Methods

This study included 37 patients who underwent NAC, and 33 patients who underwent definitive chemoradiation therapy (dCRT) as larynx-preserving treatment for locally advanced cervical esophageal cancer from 2016 to 2021. This study retrospectively investigated outcomes, with comparison between NAC and dCRT for locally advanced cervical esophageal cancer.

Results

Larynx preservation was successful for all the patients with NAC and dCRT. After NAC, the rate of complete or partial response was 78.4%, and 30 patients underwent larynx-preserving surgery. On the other hand, after dCRT, the complete response rate was 71.9%, and 4 patients underwent larynx-preserving salvage surgery. Overall survival (OS) and progression free survival were similar between the two groups. However, for the patients with resectable cervical esophageal cancer (cT1/2/3), the 2-year OS rate was significantly higher with NAC (79.9%) than with dCRT (56.8%) (P = 0.022), and the multivariate analyses identified only NAC and cN0, one of the two as a significantly independent factor associated with a better OS (NAC: P = 0.041; cN0, 1: P = 0.036).

Conclusion

The study showed that NAC as larynx-preserving surgery for resectable cervical esophageal cancer preserved function and had a better prognosis than dCRT. The authors suggest that NAC may be standard strategy for larynx preservation in patients with resectable cervical esophageal cancer.

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Acknowledgment

The authors thank the staff that participated in data collection for this study.

Author information

Authors and Affiliations

  1. Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan

    Yuto Kubo MD, PhD, Ryoko Nozaki MD, Shota Igaue MD, Daichi Utsunomiya MD, Kentaro Kubo MD, Daisuke Kurita MD, Koshiro Ishiyama MD, PhD, Junya Oguma MD, PhD & Hiroyuki Daiko MD, PhD, FACS

  2. Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan

    Shun Yamamoto MD, Yoshitaka Honma MD, PhD & Ken Kato MD, PhD

  3. Department of Radiation Oncology, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan

    Tairo Kashihara MD, PhD

Authors
  1. Yuto Kubo MD, PhD
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  2. Ryoko Nozaki MD
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  3. Shota Igaue MD
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  4. Daichi Utsunomiya MD
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  5. Kentaro Kubo MD
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  12. Ken Kato MD, PhD
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Corresponding author

Correspondence to Hiroyuki Daiko MD, PhD, FACS.

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Disclosure

Ken Kato has received research funds from Ono Pharmaceuticals, Bristol Myers Squibb, MSD, Merck Biopharma, Taiho Pharmaceutical, Bayer, AstraZeneca, Janssen, and Oncolys Biopharma, as well as honoraria from Ono Pharmaceuticals, Bristol Myers Squibb, MSD, and Taiho Pharmaceutical. Shun Yamamoto has received honoraria from ONO, BMS, MSD, and Taiho. The remaining authors have no conflicts of interest.

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Kubo, Y., Nozaki, R., Igaue, S. et al. Neoadjuvant Chemotherapy Improves Feasibility of Larynx Preservation and Prognosis in Resectable Locally Advanced Cervical Esophageal Cancer. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15432-4

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