Background: Neoadjuvant chemoradiotherapy (NCRT) plus surgery is the standard treatment for esophageal squamous cell carcinoma (ESCC); however, further analysis is needed to detail the histopathological characteristics of ESCC and their clinical significance after NCRT. This study aimed to present the pathological characteristics of ESCC and their association with prognosis after NCRT.Methods: All patients with ESCC who underwent NCRT followed by surgical resection at Sichuan Cancer Hospital (China) from January 2018 to December 2019 were included. Resection specimens of both the primary disease and lymph nodes were re-evaluated by an experienced pathologist. After NCRT, the pathological characteristics of the residual tumor were evaluated based on the Japanese residual tumor pattern, Mandard tumor regression grade (Mandard-TRG), local inflammatory infiltration classification, and lymph node status.Results: Among the 103 patients with ESCC included in this study, the pathological complete response (pCR) rate was 34% (35/103). The pCR rate of patients with poorly differentiated tumors (31/72) was higher (43.1%) than that of patients with well or moderately differentiated tumors (P<0.05). The residual tumor rate was 66% (68/103). A positive correlation was noted between the Japanese residual tumor pattern and Mandard-TRG (Kendall's tau-b =0.857, P<0.001). Tumor infiltration depth, lymph node positivity, moderate differentiation, and tumor recurrence were associated with poor oncological outcomes (P<0.05).Conclusions: Patients with poorly differentiated tumors can obtain an excellent short-term response; however, they have extremely poor long-term survival. For patients with moderately differentiated tumors, both the short-and long-term outcomes are poor. Lymph node status after NCRT is a prognostic factor for ESCC treated with NCRT.

Background: At present, the primary treatment of esophageal cancer is surgery-based comprehensive treatment, including adjuvant therapy such as chemotherapy and/or radiotherapy. However, the role of adjuvant therapy for esophageal squamous cell carcinoma (ESCC) with pathologically node-negative (pN0) disease is controversial. This study aimed to evaluate the impact of postoperative adjuvant therapy on survival in patients with pN0 ESCC.Methods: Patients with ESCC who underwent R0 esophagectomy in the Department of Thoracic Surgery of Sichuan Cancer Hospital from January 2008 to December 2013 were enrolled. Patients were divided into two groups: a surgery alone (Group S) group or a surgery + adjuvant therapy (Group S + A) group. The primary outcomes were overall survival (OS) and disease-free survival (DFS), and every consecutive case was followed up until death or the last follow-up.Results: A total of 387 patients with ESCC patients who had pN0 were enrolled in the study. After propensity score matching (PSM), each group consisted of 150 patients. In the overall cohort, the 5-year OS (75.6% vs. 69.7%; P=0.004) and 5-year DFS (64.9% vs. 48.2%; P=0.003) rates were higher in Group S + A than in Group S. In the matched samples, the same outcomes were observed (5-year OS: 75.6% vs.

Long-term survival in oesophageal squamous cell carcinoma (ESCC) is related with pathological response after neoadjuvant chemoradiotherapy (NCRT) followed by surgery. However, effective biomarkers to predict the pathologic response are still lacking. Therefore, a systematic analysis focusing on genes associated with the efficacy of chemoradiotherapy in ESCC will provide valuable insights into the regulation of molecular processes. By screening publications deposited in PubMed, we collected genes associated with the efficacy of chemoradiotherapy. A specific subnetwork was constructed using the Steiner minimum tree algorithm. Survival analysis in Kaplan-Meier Plotter online resources was performed to explore the relationship between gene mRNA expression and the prognosis of patients with ESCC. Quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting, and immunohistochemical staining (IHC) were used to evaluate the expression of key genes in cell lines and human samples. The areas under the receiver operating characteristic (ROC) curves (AUCs) were used to describe performance and accuracy. Transwell assays assessed cell migration, and cell viability was detected using the Cytotoxicity Assay. Finally, we identified 101 genes associated with efficacy of chemoradiotherapy. Additionally, specific molecular networks included some potential related genes, such as CUL3, MUC13, MMS22L, MME, UBC, VAPA, CYP1B1, and UGDH. The MMS22L mRNA expression level showed the most significant association with the ESCC patient outcome (p &lt; 0.01). Furthermore, MMS22L was downregulated at both the mRNA (p &lt; 0.001) and protein levels in tumour tissues compared with that in normal tissues. Lymph node metastasis was significantly associated with low MMS22L expression (p &lt; 0.01). MMS22L levels were inversely correlated with the NCRT response in ESCC (p &lt; 0.01). The resulting area under the ROC curve was 0.847 (95% CI: 0.7232 to 0.9703; p &lt; 0.01). In conclusion, low expression of MMS22L is associated with poor response to NCRT, worse survival, lymph node metastasis, and enhanced migration of tumour cells in ESCC.

Esophageal squamous cell carcinoma (ESCC) has high mortality in China. The cornerstone of treatment for resectable esophageal cancer is still surgery. It is vital to find the regularity of lymph node metastasis and the value of dissection for thoracic ESCC in China, to provide a basis for accurate staging and the relationship between overall survival (OS) and lymph node dissection. Cases were collected from 2957 patients in Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database (SCH-ECCM Database) from January 2010 to August 2017. The stations of lymph node were referenced according to CSCO diagnosis and treatment guidelines and JES, 11th Ed. According to the frequency and patient’s survival of metastases to each station of investigated tumor location were used to calculate the Efficacy Index (EI). EI was calculated by multiplying the frequency (%) and 5-year survival rate of metastases (%) in patients, and then dividing by the number of 100. The median follow-up time was 59.5 months. The EI was high in supraclavicular and mediastinal zones in patients with upper esophageal tumors, and the EI of 106recR was 13.72, which was the highest among lymph node stations. The EI was high in mediastinal zone followed by celiac and supraclavicular zones in patients with middle esophageal tumors, 104R with EI of 15.54 was the highest among lymph node stations. As for patients with lower esophageal tumors, the EI was high in celiac zone followed by mediastinal zones, the EI of left gastric artery was 10.86, over every lymph node stations. The EI of right recurrent nerve lymph nodes is the highest in upper esophageal cancer, as for middle esophageal cancer right supraclavicular lymph nodes had high metastasis rate and EI, but the left gastric lymph nodes had high metastasis rate and EI in the lower esophageal cancer. Although the lymph node metastasis rate of ESCC is still high, the more efficient lymphadenectomy should be considered based on further studies.