Published in:
01-05-2018 | Original Scientific Report
Evaluation of Prognostic Factors for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery
Published in: World Journal of Surgery | Issue 5/2018
Login to get accessAbstract
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.