Singh Lovepreet, Tandup Cherring, Thakur Manish, Sekar Aravind, Samanta Jayanta, Nagaraj Satish Subbiah, Sahu Swapnesh Kumar, Sakaray Yashwant, Santosh R N Naga, Kurdia Kailash, Thakur Vipul
General Surgery, Post Graduate Institute of Medical Education and Research, Room No. 26 Nehru Hospital, Chandigarh, India.
Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Gastrointest Cancer. 2025 Jan 14;56(1):43. doi: 10.1007/s12029-024-01150-3.
Neoadjuvant chemotherapy followed by esophagectomy is the usual approach to manage esophageal squamous cell carcinoma (ESCC). The optimal interval to operate after completion of neoadjuvant chemoradiotherapy (NACRT) still remains controversial.
A prospective study was conducted to observe and compare postoperative complications and pathological outcomes in patients with squamous cell carcinoma of the esophagus who underwent NACRT followed by surgery within 8 weeks or after 8 weeks of NACRT completion. The pathological complete response was assessed using the Mandard tumor regression grade. Morbidity and mortality were compared and were graded using the Clavien-Dindo scale.
The study included 50 patients, 19 patients in the < 8-week group and 31 in the > 8-week group study. Patients underwent thoracoscopy-assisted esophagectomy with neoesophagus formation using gastric conduit. There was a significant difference in mortality between the two groups, with three mortalities in the < 8-week group and none in the other group (p = 0.022). Postoperative complications and pathological outcomes did not have a statistically significant difference between the two groups.
The pathological response in ESCC cases does not appear to be impacted by the interval between NACRT and surgery; nevertheless, early surgery was associated with a higher risk of mortality.
新辅助化疗后行食管切除术是治疗食管鳞状细胞癌（ESCC）的常用方法。新辅助放化疗（NACRT）完成后进行手术的最佳间隔时间仍存在争议。
进行一项前瞻性研究，观察和比较接受NACRT的食管鳞状细胞癌患者在NACRT完成后8周内或8周后接受手术的术后并发症和病理结果。使用曼德尔肿瘤消退分级评估病理完全缓解情况。比较发病率和死亡率，并使用Clavien-Dindo量表进行分级。
该研究纳入50例患者，<8周组19例，>8周组31例。患者接受胸腔镜辅助食管切除术并使用胃管道形成新食管。两组之间的死亡率存在显著差异，<8周组有3例死亡，另一组无死亡（p = 0.022）。两组之间的术后并发症和病理结果没有统计学上的显著差异。
ESCC病例的病理反应似乎不受NACRT与手术间隔时间的影响；然而，早期手术与较高的死亡风险相关。
