The role of adjuvant chemotherapy in esophageal cancer patients after neoadjuvant chemotherapy plus surgery.


Journal

Esophagus : official journal of the Japan Esophageal Society
ISSN: 1612-9067
Titre abrégé: Esophagus
Pays: Japan
ID NLM: 101206627

Informations de publication

Date de publication:
07 2021
Historique:
received: 03 08 2020
accepted: 28 12 2020
pubmed: 14 2 2021
medline: 26 3 2022
entrez: 13 2 2021
Statut: ppublish

Résumé

Esophageal cancer typically has a poor prognosis. While neoadjuvant chemotherapy (NAC) is reported to be effective for esophageal cancer patients, the prognosis of patients for whom NAC is ineffective remains poor. In total, 113 patients with thoracic esophageal squamous cell carcinoma who were treated between January 2006 and December 2015 were enrolled. These patients received NAC followed by radical surgery and had three or more pathologic positive lymph nodes. The effectiveness and feasibility of adjuvant chemotherapy (AC) were evaluated. Forty patients received AC (AC(+) group) and 73 patients did not (AC(-) group). Two-year relapse-free survival (RFS) rates of the AC(+) and AC(-) groups were 30.0% and 28.8%, respectively (p = 0.47). These patients were further divided into two subgroups, i.e., those with 3-6 positive lymph nodes (3-6 subgroup) and those with ≥ 7 positive lymph nodes (≥ 7 subgroup). Within the 3-6 subgroup (72 patients), 2-year RFS rates of the AC(+) and AC(-) groups were 38.5% and 33.9%, respectively (p = 0.31). Within the ≥ 7 subgroup (41 patients), 2-year RFS rates of the AC(+) and AC(-) groups were 25.9% and 7.1%, respectively (p = 0.04). AC may offer a significant additional benefit to the prognosis of esophageal cancer patients who have many positive lymph nodes even after NAC.

Sections du résumé

BACKGROUND
Esophageal cancer typically has a poor prognosis. While neoadjuvant chemotherapy (NAC) is reported to be effective for esophageal cancer patients, the prognosis of patients for whom NAC is ineffective remains poor.
METHODS
In total, 113 patients with thoracic esophageal squamous cell carcinoma who were treated between January 2006 and December 2015 were enrolled. These patients received NAC followed by radical surgery and had three or more pathologic positive lymph nodes. The effectiveness and feasibility of adjuvant chemotherapy (AC) were evaluated.
RESULTS
Forty patients received AC (AC(+) group) and 73 patients did not (AC(-) group). Two-year relapse-free survival (RFS) rates of the AC(+) and AC(-) groups were 30.0% and 28.8%, respectively (p = 0.47). These patients were further divided into two subgroups, i.e., those with 3-6 positive lymph nodes (3-6 subgroup) and those with ≥ 7 positive lymph nodes (≥ 7 subgroup). Within the 3-6 subgroup (72 patients), 2-year RFS rates of the AC(+) and AC(-) groups were 38.5% and 33.9%, respectively (p = 0.31). Within the ≥ 7 subgroup (41 patients), 2-year RFS rates of the AC(+) and AC(-) groups were 25.9% and 7.1%, respectively (p = 0.04).
CONCLUSIONS
AC may offer a significant additional benefit to the prognosis of esophageal cancer patients who have many positive lymph nodes even after NAC.

Identifiants

pubmed: 33580452
doi: 10.1007/s10388-020-00811-z
pii: 10.1007/s10388-020-00811-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

559-565

Références

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Auteurs

Norihiro Matsuura (N)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Makoto Yamasaki (M)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan. myamasaki@gesurg.med.osaka-u.ac.jp.

Kotaro Yamashita (K)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Koji Tanaka (K)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Tomoki Makino (T)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Takuro Saito (T)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Kazuyoshi Yamamoto (K)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Tsuyoshi Takahashi (T)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Yukinori Kurokawa (Y)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Masaaki Motoori (M)

Department of Surgery, Osaka General Medical Center, Osaka, Japan.

Yutaka Kimura (Y)

Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan.

Kiyokazu Nakajima (K)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Hidetoshi Eguchi (H)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

Yuichiro Doki (Y)

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.

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