Predictors of Survival in Esophageal Squamous Cell Carcinoma with Pathologic Major Response after Neoadjuvant Chemoradiation Therapy and Surgery: The Impact of Chemotherapy Protocols
Journal
BioMed Research International
Journal Volume
2016
Date Issued
2016
Author(s)
Abstract
Tumor recurrence is an important problem threatening esophageal cancer patients after surgery, even when they achieve a pathologic major response (pMR) after neoadjuvant concurrent chemoradiation therapy (CCRT). The predictors related to overall survival and disease progression for these patients remain elusive. We aimed to identify factors that predict disease progression and overall survival in esophageal squamous cell carcinoma (SCC) patients who achieve a pMR after neoadjuvant CCRT followed by surgery. We conducted a retrospective study to analyze the factors influencing survival and disease progression after esophagectomy for esophageal cancer patients who had a major response to CCRT, which is defined by complete pathological response or microscopic residual disease without lymph node metastasis. From our study cohort, 285 patients underwent CCRT and subsequent esophagectomy; 171 (60%) of these patients achieved pMR. After excluding patients with lymph node metastases, incomplete clinical data, and adenocarcinomas, we enrolled 117 patients in this study. We found that the CCRT regimen was the only factor that influenced overall survival. The overall survival of the patients receiving taxane-incorporated CCRT was superior to that of patients receiving traditional cisplatin and 5-fluorouracil (PF) (P = 0.01 1). The CCRT regimen can significantly influence the clinical outcome of esophageal SCC patients who achieve pMR after neoadjuvant CCRT and esophagectomy. Incorporation of taxanes into cisplatin-based CCRT may be associated with prolonged survival. ? 2016 Chia-Ying Li et al.
SDGs
Other Subjects
cisplatin; docetaxel; fluorouracil; folinic acid; paclitaxel; cisplatin; fluorouracil; taxoid; adjuvant chemoradiotherapy; adjuvant therapy; adult; advanced cancer; anastomosis leakage; Article; cancer combination chemotherapy; cancer patient; cancer radiotherapy; cancer surgery; cancer survival; clinical outcome; cohort analysis; controlled study; disease course; drug megadose; esophageal adenocarcinoma; esophageal squamous cell carcinoma; esophagus resection; female; follow up; human; induction chemotherapy; low drug dose; major clinical study; male; middle aged; minimal residual disease; multiple organ failure; neoadjuvant therapy; overall survival; pathologic major response; postoperative infection; progression free survival; radiation dose fractionation; radiotherapy dosage; retrospective study; sepsis; surgical mortality; treatment response; aged; chemoradiotherapy; disease exacerbation; esophageal squamous cell carcinoma; esophagus tumor; genetic predisposition; lymph node metastasis; mortality; multimodality cancer therapy; neoadjuvant therapy; procedures; squamous cell carcinoma; surgery; treatment outcome; x-ray computed tomography; Aged; Carcinoma, Squamous Cell; Chemoradiotherapy; Cisplatin; Combined Modality Therapy; Disease Progression; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Female; Fluorouracil; Genetic Predisposition to Disease; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoadjuvant Therapy; Retrospective Studies; Surgical Procedures, Operative; Taxoids; Tomography, X-Ray Computed; Treatment Outcome
Publisher
Hindawi Limited
Type
journal article