TITLE:
Neoadjuvant Chemotherapy for Clinical Stage II and III Thoracic Esophageal Squamous Cell Carcinoma with Curative Esophagectomy
AUTHORS:
Masahide Ikeguchi, Yusuke Kohno, Kyoichi Kihara, Kazunori Suzuki, Kanenori Endo, Seiichi Nakamura, Takashi Sawada, Tetsu Shimizu, Tomoyuki Matsunaga, Yoji Fukumoto, Hiroaki Saito
KEYWORDS:
Esophageal Squamous Cell Carcinoma, Histopathological Grade, Neoadjuvant Chemotherapy, Prognosis
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.15,
December
11,
2015
ABSTRACT: Esophageal squamous cell carcinoma (ESCC) is a gastrointestinal carcinoma
with a poor prognosis. To improve the survival of patients with this disease, neoadjuvant
chemotherapy (NAC) has been introduced. However, the survival benefits of NAC or
the correlation between NAC and postoperative complications have not been well considered.
In the present study, we retrospectively investigated the clinicopathological effectiveness
of NAC in patients with clinical stage II and III thoracic ESCC. This retrospective
study enrolled 63 patients with clinical stage II and III thoracic ESCC, who underwent
resection of the thoracic esophagus and three-field lymph node dissection between
January 2007 and December 2013. NAC with cisplatin plus 5-fluorouracil (5-FU) was
introduced in 38 patients. NAC did not correlate with the occurrence of postoperative
complications. The 5-year disease-free survival (DFS) rate of the 38 patients with
NAC (41.6%) was similar to that for the 25 patients who did not receive NAC (38.1%; P = 0.784). However, we found that the
DFS of 17 patients with histopathological Grade 2 and 3 tumors who received NAC
(5-year DFS rate: 58.1%) was significantly higher than that of 21 patients with
low histopathological grade tumors who received NAC (5-year DFS rate: 28.6%), or
than that of the 25 patients who did not receive NAC (38.1%). Moreover, we found
that the effectiveness of NAC assessed macroscopically did not correlate with the
effectiveness of NAC assessed microscopically. These findings may indicate that
preoperative estimation of NAC effectiveness is important in avoiding unnecessary
adverse drug effects caused by NAC, and in prolonging the survival of patients with
thoracic ESCC.