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01-01-2021 | Cytostatic Therapy | Original Article

Controlling lymph node micrometastases by neoadjuvant chemotherapy affects the prognosis in advanced esophageal squamous cell carcinoma

Authors: Yoko Hiraki, Yutaka Kimura, Motohiro Imano, Hiroaki Kato, Mitsuru Iwama, Osamu Shiraishi, Atsushi Yasuda, Masayuki Shinkai, Tomoki Makino, Masaaki Motoori, Makoto Yamasaki, Hiroshi Miyata, Takao Satou, Taroh Satoh, Hiroshi Furukawa, Masahiko Yano, Yuichiro Doki, Takushi Yasuda

Published in: Surgery Today | Issue 1/2021

Abstract

Purpose

The purpose of this study is to determine the clinical significance of micrometastases after neoadjuvant chemotherapy (NAC) and the difference in controlling micrometastases using different NAC regimens in resectable advanced esophageal squamous cell carcinoma (ESCC).

Methods

We analyzed patients with ESCC who underwent esophagectomy with lymph node dissection after NAC with Adriamycin + cisplatin + 5-fluorouracil (ACF) or docetaxel + cisplatin + 5-fluorouracil (DCF). Micrometastasis was defined as a single isolated cancer cell or cluster of cancer cells on the cervical, recurrent nerve, or abdominal LNs as shown by immunohistochemical staining with anti-cytokeratin antibody (AE1/AE3). The associations between micrometastases, recurrence, prognosis, and regimen differences were investigated.

Results

One hundred and one cases (ACF group: 51 cases; DCF group: 50 cases) were analyzed. Micrometastases occurred in 24 patients (23.8%): 17/51 (33.3%) in the ACF group and 7/50 (13.5%) in the DCF group (p = 0.0403). The 5-year recurrence-free survival (RFS) rates for patients without (n = 77) and with (n = 24) micrometastases were 62 and 32%, respectively, (hazard ratio, 2.158; 95% confidence interval, 1.170–3.980; stratified log-rank test, p = 0.0115). A multivariate analysis showed that stage pN1 or higher and micrometastases were significant risk factors affecting RFS.

Conclusion

In resectable advanced ESCC, controlling micrometastases in the LNs after NAC varied by regimen and may be associated with preventing ESCC recurrence.

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Title: Controlling lymph node micrometastases by neoadjuvant chemotherapy affects the prognosis in advanced esophageal squamous cell carcinoma
Authors: Yoko Hiraki
Yutaka Kimura
Motohiro Imano
Hiroaki Kato
Mitsuru Iwama
Osamu Shiraishi
Atsushi Yasuda
Masayuki Shinkai
Tomoki Makino
Masaaki Motoori
Makoto Yamasaki
Hiroshi Miyata
Takao Satou
Taroh Satoh
Hiroshi Furukawa
Masahiko Yano
Yuichiro Doki
Takushi Yasuda
Publication date: 01-01-2021
Publisher: Springer Singapore
Keyword: Cytostatic Therapy
Published in: Surgery Today / Issue 1/2021
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-020-02059-7

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Controlling lymph node micrometastases by neoadjuvant chemotherapy affects the prognosis in advanced esophageal squamous cell carcinoma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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Acknowledgment to reviewers

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