Torigoe Rikuya, Oshikiri Taro, Goto Hironobu, Koterazawa Yasuhumi, Sawada Ryuichiro, Ikeda Taro, Harada Hitoshi, Urakawa Naoki, Hasegawa Hiroshi, Kanaji Shingo, Yamashita Kimihiro, Matsuda Takeru, Kakeji Yoshihiro
Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Division of Gastrointestinal Surgery and Surgical Oncology, Graduate School of Medicine, Toon, Japan
Anticancer Res. 2024 Dec;44(12):5485-5493. doi: 10.21873/anticanres.17374.
BACKGROUND/AIM: Squamous cell carcinoma antigen (SCC) is widely used as a tumor marker for esophageal cancer. In this study, we investigated the relationship between SCC and long-term outcomes in patients with esophageal squamous cell carcinoma after neoadjuvant chemotherapy (NAC) followed by minimally invasive esophagectomy (MIE).
Between 2010 and 2018, 124 patients with ESCC who underwent MIE after NAC (cisplatin plus 5-fluorouracil) were included. Patients were divided into low and high groups based on their pre-NAC SCC level, according to the cut-off value determined using a receiver operating characteristic curve. These two patient groups were further divided into subgroups by receiver operating characteristics according to whether SCC was low or high after NAC.
For overall survival (OS), the cut-off value for SCC pre-NAC was 0.9 ng/ml. Ninety-six patients were in the high SCC group (≥0.9 ng/ml) and 28 patients were in the low SCC group (<0.9 ng/ml) prior to NAC. The patients were then divided into pre-NAC/post-NAC SCC subgroups accordingly: low/low SCC (n=7), low/high SCC (n=21), high/low SCC (n=53), and high/high SCC (n=43). The 5-year OS rates were 100%, 66.7%, 50.9%, and 32.6%, respectively. In the multivariate analysis for OS, a high/high pre-NAC/post-NAC SCC status was an independent prognostic factor for poorer OS, along with pathological N stage.
For patients with esophageal squamous cell carcinoma treated with NAC followed by MIE, a high SCC level prior to NAC which was also high after NAC was an independent prognostic factor and might contribute to deciding the need for adjuvant therapy.
背景/目的：鳞状细胞癌抗原（SCC）被广泛用作食管癌的肿瘤标志物。在本研究中，我们调查了新辅助化疗（NAC）联合微创食管切除术（MIE）后，食管鳞状细胞癌患者中SCC与长期预后的关系。
纳入2010年至2018年间124例行NAC（顺铂加5-氟尿嘧啶）后行MIE的食管鳞状细胞癌患者。根据使用受试者工作特征曲线确定的临界值，将患者按NAC前SCC水平分为低水平组和高水平组。这两组患者再根据NAC后SCC是低还是高，通过受试者工作特征进一步分为亚组。
对于总生存期（OS），NAC前SCC的临界值为0.9 ng/ml。NAC前，96例患者属于SCC高水平组（≥0.9 ng/ml），28例患者属于SCC低水平组（<0.9 ng/ml）。然后将患者相应地分为NAC前/NAC后SCC亚组：低/低SCC（n=7）、低/高SCC（n=21）、高/低SCC（n=53）和高/高SCC（n=43）。5年总生存率分别为100%、66.7%、50.9%和32.6%。在OS的多因素分析中，NAC前/NAC后SCC高/高状态与病理N分期一样，是OS较差的独立预后因素。
对于接受NAC联合MIE治疗的食管鳞状细胞癌患者，NAC前SCC水平高且NAC后仍高是独立的预后因素，可能有助于决定是否需要辅助治疗。
