Controlling lymph node micrometastases by neoadjuvant chemotherapy affects the prognosis in advanced esophageal squamous cell carcinoma.
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Carcinoma, Squamous Cell
/ drug therapy
Esophageal Neoplasms
/ mortality
Esophagectomy
Female
Humans
Lymph Node Excision
Lymph Nodes
/ pathology
Lymphatic Metastasis
/ prevention & control
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Micrometastasis
/ pathology
Neoplasm Recurrence, Local
/ prevention & control
Prognosis
Risk Factors
Survival Rate
Esophageal squamous cell carcinoma
Micrometastases
Neoadjuvant chemotherapy
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
22
04
2020
accepted:
15
06
2020
pubmed:
1
7
2020
medline:
16
6
2021
entrez:
30
6
2020
Statut:
ppublish
Résumé
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). 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. 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. In resectable advanced ESCC, controlling micrometastases in the LNs after NAC varied by regimen and may be associated with preventing ESCC recurrence.
Identifiants
pubmed: 32596796
doi: 10.1007/s00595-020-02059-7
pii: 10.1007/s00595-020-02059-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
118-126Références
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