Pathological stage after neoadjuvant chemoradiation and esophagectomy superiorly predicts survival in patients with esophageal squamous cell carcinoma
Journal
Radiotherapy and Oncology
Journal Volume
115
Journal Issue
1
Pages
9-15
Date Issued
2015
Abstract
Background and purpose To assess the usefulness of pathological stage according to the 7th edition of the Union for International Cancer Control-American Joint Committee on Cancer (UICC-AJCC) as a prognostic tool in patients undergoing neoadjuvant chemoradiation followed by esophagectomy (trimodality therapy, TMT) for locally advanced esophageal squamous cell carcinoma. Material and methods One hundred twenty-five eligible patients completing TMT were enrolled for analysis. The clinical (cTNM7) and pathological (ypTNM7) stage groups of their tumors were prospectively classified, and re-grouped by the 6th edition (ypTNM6). Survival was analyzed using the Kaplan-Meier method. The Cox proportional hazard model and the Akaike information criterion (AIC) were used to compare the performance of staging systems. Results With a median follow-up of 24.6 months, 54 patients (43.2%) died. Forty patients (32%) achieved pathological complete remission (pCR). The median survival was 31.8 months. On multivariate analysis, ypTNM7 (but not pCR or pN) was the only independent factor affecting overall survival (p < 0.001). The ypTNM7 was superior to cTNM7 or ypTNM6 in predicting both overall and recurrence-free survival after TMT based on AIC values and Cox proportional hazard model analysis. Conclusions In patients with locally advanced esophageal squamous cell carcinoma undergoing TMT, ypTNM7 is the best predictor of survival. ? 2015 Elsevier Ireland Ltd. All rights reserved.
SDGs
Other Subjects
cetuximab; cisplatin; fluorouracil; folinic acid; paclitaxel; adjuvant chemoradiotherapy; adult; aged; Article; cancer combination chemotherapy; cancer regression; cancer staging; cancer survival; continuous infusion; esophageal squamous cell carcinoma; esophagus resection; female; follow up; histopathology; human; induction chemotherapy; Kaplan Meier method; major clinical study; male; multimodality cancer therapy; outcome assessment; overall survival; priority journal; proportional hazards model; recurrence free survival; adjuvant therapy; Carcinoma, Squamous Cell; chemoradiotherapy; Esophageal Neoplasms; esophagus resection; middle aged; prognosis; Adult; Aged; Carcinoma, Squamous Cell; Chemoradiotherapy; Esophageal Neoplasms; Esophagectomy; Female; Humans; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Prognosis; Proportional Hazards Models
Publisher
Elsevier Ireland Ltd
Type
journal article