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Annals of Surgical Oncology
Published in:

16-05-2024 | Esophageal Cancer | Thoracic Oncology

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

Authors: Yuto Kubo, MD, PhD, Ryoko Nozaki, MD, Shota Igaue, MD, Daichi Utsunomiya, MD, Kentaro Kubo, MD, Shun Yamamoto, MD, Daisuke Kurita, MD, Tairo Kashihara, MD, PhD, Koshiro Ishiyama, MD, PhD, Yoshitaka Honma, MD, PhD, Junya Oguma, MD, PhD, Ken Kato, MD, PhD, Hiroyuki Daiko, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 8/2024

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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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Metadata
Title
Neoadjuvant Chemotherapy Improves Feasibility of Larynx Preservation and Prognosis in Resectable Locally Advanced Cervical Esophageal Cancer
Authors
Yuto Kubo, MD, PhD
Ryoko Nozaki, MD
Shota Igaue, MD
Daichi Utsunomiya, MD
Kentaro Kubo, MD
Shun Yamamoto, MD
Daisuke Kurita, MD
Tairo Kashihara, MD, PhD
Koshiro Ishiyama, MD, PhD
Yoshitaka Honma, MD, PhD
Junya Oguma, MD, PhD
Ken Kato, MD, PhD
Hiroyuki Daiko, MD, PhD, FACS
Publication date
16-05-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-15432-4

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