Prognostic Factors for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Docetaxel/Cisplatin/5-Fluorouracil Followed by Surgery.

Abstract

BACKGROUND:

Preoperative therapy followed by surgery has become the clinical standard for resectable advanced esophageal cancer. Several studies showed that neoadjuvant docetaxel/cisplatin/5-fluorouracil (DCF) resulted in a high response rate and prolonged relapse-free survival, but what constitutes appropriate additional therapy is unknown.

METHODS:

A total of 101 consecutive patients with cStage I B-III esophageal cancer were treated with preoperative DCF between April 2011 and December 2015. After completing 2 cycles of DCF neoadjuvant chemotherapy (NAC), esophagectomy was performed. We investigated prognostic factors and recurrence patterns in patients with resectable esophageal cancer who underwent DCF NAC followed by surgery.

RESULTS:

Univariate analysis showed that performance status (hazard ratio, HR 2.85; p = 0.033), clinical response (HR 2.16; p = 0.048), pT stage (HR 2.20; p = 0.047), pN stage (HR 5.83; p< 0.001), pathological curability (HR 5.64; p = 0.038), and histological grade (HR 1.92; p = 0.048) were significant factors. Multivariate prognostic analysis revealed that pN stage and pathological curability were significant prognostic factors (HR 11.20; p < 0.001, and HR 27.41; p = 0.007, respectively). In addition, based on the number of metastatic lymph nodes (LNs), the difference in overall survival was the largest between patients with ≤2 and ≥3 metastatic LNs (HR 5.83; p< 0.001). Distant metastatic recurrence increased significantly in patients with 3 or more pathologically confirmed metastatic LNs (p = 0.008).

CONCLUSION:

Distant recurrence occurred more frequently and prognosis was poorer in patients with 3 or more pathologically confirmed metastatic LNs; they might need additional systemic therapy.

• Authors: Keijiro Sugimura, Hiroshi Miyata, Naoki Shinno, Hajime Ushigome, Kei Asukai, Yoshitomo Yanagimoto, Shinnichiro Hasegawa, Yusuke Takahashi, Daisaku Yamada, Kazuyoshi Yamamoto, Junichi Nishimura, Masaaki Motoori, Hiroshi Wada, Hidenori Takahashi, Masayoshi Yasui, Takeshi Omori, Masayuki Ohue, Masahiko Yano
• Journal: Oncology (Oncology) Vol. 97 Issue 6 Pg. 348-355 ( 2019) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 31461716 (Publication Type: Journal Article)
• Copyright: © 2019 S. Karger AG, Basel.

Chemical References

• Docetaxel
• Cisplatin
• Fluorouracil

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Docetaxel (administration & dosage)
• Esophageal Neoplasms (drug therapy, mortality, pathology, surgery)
• Esophageal Squamous Cell Carcinoma (drug therapy, mortality, pathology, surgery)
• Female
• Fluorouracil (administration & dosage)
• Humans
• Lymphatic Metastasis
• Male
• Middle Aged
• Prognosis