Prognostic Factors for Patients With Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemotherapy Followed by Surgery.

BACKGROUND/AIM: Neoadjuvant chemotherapy (NAC) followed by surgery is a standard treatment for patients with locally advanced esophageal cancer. This study aimed to identify patients who might be eligible for postoperative adjuvant therapy.

PATIENTS AND METHODS

We reviewed the surgical outcomes of 84 patients who received NAC followed by esophagectomy to treat esophageal squamous cell carcinoma (ESCC) and revealed prognostic factors associated with locally advanced ESCC.

RESULTS

Univariate and multivariate analyses revealed the pretreatment level of squamous cell carcinoma-related antigen [SCC-A; hazard ratio (HR)=1.50, p=0.01], ypT ≥3 (HR=2.51; p=0.04), ypN ≥1 (HR=5.87; p=0.01), ypM1 (HR=2.38; p=0.049), and lymphovascular invasion (HR=3.12, p=0.049) as significant independent covariates for recurrence-free survival (RFS). The 5-year RFS rates for patients with 0-1, 2-3, or 4-5 of these indicators of poor prognosis were 97.1%, 51.2%, and 6.7% (p≤0.001 for all). Recurrence rates among these groups also significantly differed at 2.9%, 50.0%, and 93.3% (p<0.0001).

CONCLUSION

Pretreatment SCC-A, ypT, ypN, ypM, and lymphovascular invasion were significantly associated with RFS in patients with ESCC who received NAC followed by surgery. The status of these prognostic factors in ESCC might indicate a need for postoperative adjuvant therapy after NAC followed by surgery.