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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2019

01-09-2019 | Lymphopenia | Thoracic Oncology

Treatment-Related Lymphopenia Predicts Pathologic Complete Response and Recurrence in Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemoradiotherapy

Authors: Qiaoqiao Li, MD, Sha Zhou, PhD, Shiliang Liu, MD, Songran Liu, MD, Hong Yang, MD, Lei Zhao, MD, Mengzhong Liu, MD, Yonghong Hu, MD, Mian Xi, MD

Published in: Annals of Surgical Oncology | Issue 9/2019

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Abstract

Purpose

To investigate the relationship between treatment-related lymphopenia and pathologic response to neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC).

Methods

Between 2002 and 2016, 220 ESCC patients treated with neoadjuvant CRT followed by surgery were retrospectively analyzed. Absolute lymphocyte count was determined before, during, and 1 month after neoadjuvant CRT. Treatment-related lymphopenia was graded using Common Terminology Criteria for Adverse Events version 4.0. Relationship between lymphopenia with pathologic complete response (pCR) and recurrence were evaluated.

Results

Ninety-five patients (43.2%) achieved a pCR after neoadjuvant CRT and 71 patients (32.3%) developed recurrences. The incidence of grade 0, 1, 2, 3, and 4 lymphopenia during CRT were 1.8%, 6.8%, 31.4%, 38.2% and 21.8%, respectively. Patients with grade 4 lymphopenia had a significantly lower pCR rate than those with grade 0-3 lymphopenia (22.9% vs. 48.8%, P = 0.001). Moreover, grade 4 lymphopenia was significantly associated with a higher risk of recurrences (45.8% vs. 28.5%, P = 0.023). Multivariable analysis identified that primary tumor length, tumor location, and radiation dose were independent predictors for grade 4 lymphopenia.

Conclusions

ESCC patients with grade 4 lymphopenia during neoadjuvant CRT were associated with a significantly lower pCR rate and a higher recurrence risk.
Appendix
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Metadata
Title
Treatment-Related Lymphopenia Predicts Pathologic Complete Response and Recurrence in Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemoradiotherapy
Authors
Qiaoqiao Li, MD
Sha Zhou, PhD
Shiliang Liu, MD
Songran Liu, MD
Hong Yang, MD
Lei Zhao, MD
Mengzhong Liu, MD
Yonghong Hu, MD
Mian Xi, MD
Publication date
01-09-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07334-7

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