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General Thoracic and Cardiovascular Surgery

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01-04-2016 | Original Article

Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis

Authors: Keishi Yamashita, Natsuya Katada, Hiromitsu Moriya, Kei Hosoda, Hiroaki Mieno, Chikatoshi Katada, Wasaburo Koizumi, Keika Hoshi, Masahiko Watanabe

Published in: General Thoracic and Cardiovascular Surgery | Issue 4/2016

Abstract

Background

Neoadjuvant chemotherapy (NAC) with CF (cisplatin/5-FU) was demonstrated to improve survival of clinical stage II/III (cStage II/III) esophageal squamous cell carcinoma (ESCC), however prognostic outcome remains unsatisfactory. We have recently reported preliminary potentiality of short-term survival benefit by NAC with DCF (docetaxel/cisplatin/5-FU).

Patients and methods

Thirty-eight ESCC patients who underwent DCF NAC between 2009 and 2012 were investigated for prognosis with a median follow-up period of 49 months as compared to those with CF NAC.

Results

(1) ESCC patients with DCF NAC showed 66 % of 3-year progression-free survival (PFS), which is significantly superior to that of CF NAC (38 %) (p = 0.018). ESCC patients with DCF NAC showed 79 % of 3-year overall survival (OS), which is marginally significantly superior to that of CF NAC (65 %) (p = 0.093). (2) The multivariate Cox proportional hazards model revealed that DCF NAC was an independent prognostic factor for PFS (p = 0.0013) and OS (p = 0.047), respectively, when adjusted for patient sex, age, cT, cN, and preoperative borderline resectability. (3) Patients with more advanced stage were rather frequently included in DCF NAC than in CF NAC, however there was no significant difference. Nevertheless, propensity score (PS) to predict DCF NAC was significantly higher than CF NAC (p = 0.019). (4) Both NAC and PS were again applied to the multivariate Cox proportional hazards model, and DCF NAC was the only remnant prognostic indicator for PFS (p = 0.0044) and OS (p = 0.063).

Conclusion

Prognosis may be significantly improved in cStage II/III ESCC patients who underwent DCF NAC than those with CF NAC.

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Title: Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis
Authors: Keishi Yamashita
Natsuya Katada
Hiromitsu Moriya
Kei Hosoda
Hiroaki Mieno
Chikatoshi Katada
Wasaburo Koizumi
Keika Hoshi
Masahiko Watanabe
Publication date: 01-04-2016
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 4/2016
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-016-0626-3

At a glance: The STEP trials

Springer Medicine

Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis

Abstract

Background

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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