|Title:||Pathological stage after neoadjuvant chemoradiation and esophagectomy superiorly predicts survival in patients with esophageal squamous cell carcinoma||Authors:||Wang, Chia Chun
Cheng, Jason Chia Hsien
Tsai, Chiao Ling
Lin, Chia Chi
Hsu, Feng Ming
|Keywords:||Esophageal squamous cell carcinoma | Neoadjuvant | Trimodality therapy | UICC-AJCC Stage||Issue Date:||1-Jan-2015||Publisher:||ELSEVIER IRELAND LTD||Journal Volume:||115||Journal Issue:||1||Start page/Pages:||9||Source:||Radiotherapy and Oncology||Abstract:||
© 2015 Elsevier Ireland Ltd. All rights reserved. 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.
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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