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01-12-2021 | Metastasis | Original Article

The Role of Adjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma Patients with Pathological Positive Lymph Nodes After Neoadjuvant Chemotherapy Followed by Esophagectomy: a Single Institute Retrospective Analysis

Authors: Takeharu Imai, Yoshihiro Tanaka, Yuta Sato, Junichi Mase, Tomonari Suetsugu, Masahiro Fukada, Itaru Yasufuku, Yoshinori Iwata, Ryutaro Mori, Hisashi Imai, Takazumi Kato, Naoki Okumura, Nobuhisa Matsuhashi, Takao Takahashi, Manabu Futamura, Kazuhiro Yoshida

Published in: Indian Journal of Surgical Oncology | Issue 4/2021

Abstract

The need for adjuvant therapy after radical resection for patients with stage II–III thoracic esophageal squamous cell carcinoma (TESCC) who have undergone neoadjuvant chemotherapy (NAC) has not been determined. Since recurrence can occur after radical resection and since the prognosis is still poor, it is necessary to consider additional treatment strategies, including adjuvant chemotherapy. We retrospectively investigated the significance of adjuvant therapy after NAC followed by radical resection for TESCC. Between 2008 and 2018, 115 patients with clinical stage II–III underwent radical subtotal esophagectomy after neoadjuvant therapy. Among them, 62 were analyzed, excluding patients with T4 tumors and patients who had undergone R plus resection or who were receiving preoperative chemoradiotherapy. We compared patients who received adjuvant chemotherapy with those who only received observation; we examined overall survival (OS) and recurrence rates. Twenty-nine patients (46.7%) had lymph node metastasis, 12 of whom received adjuvant chemotherapy (41.3%). The recurrence rates for patients with and without lymph node metastasis were 55.1 % and 15.1%, respectively (p = 0.0022). Among patients with lymph node metastasis, there was no significant difference in the recurrence rate (p = 0.9270) or OS (p = 0.5416) based on the administration of adjuvant chemotherapy. However, in 15 patients with two or more positive lymph nodes, adjuvant chemotherapy increased OS (p = 0.0404). Adjuvant chemotherapy was associated with improved OS in clinical stage II–III TESCC patients with two or more pathological positive lymph nodes after NAC followed by radical surgery.

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Title: The Role of Adjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma Patients with Pathological Positive Lymph Nodes After Neoadjuvant Chemotherapy Followed by Esophagectomy: a Single Institute Retrospective Analysis
Authors: Takeharu Imai
Yoshihiro Tanaka
Yuta Sato
Junichi Mase
Tomonari Suetsugu
Masahiro Fukada
Itaru Yasufuku
Yoshinori Iwata
Ryutaro Mori
Hisashi Imai
Takazumi Kato
Naoki Okumura
Nobuhisa Matsuhashi
Takao Takahashi
Manabu Futamura
Kazuhiro Yoshida
Publication date: 01-12-2021
Publisher: Springer India
Keywords: Metastasis
Esophageal Cancer
Esophagus Resection
Esophageal Cancer
Esophagus Resection
Cytostatic Therapy
Published in: Indian Journal of Surgical Oncology / Issue 4/2021
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI: https://doi.org/10.1007/s13193-021-01419-0

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The Role of Adjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma Patients with Pathological Positive Lymph Nodes After Neoadjuvant Chemotherapy Followed by Esophagectomy: a Single Institute Retrospective Analysis

Abstract

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