Upfront surgery and pathological stage-based adjuvant chemoradiation strategy in locally advanced esophageal squamous cell carcinoma

Abstract

Adjuvant chemoradiation is reported to have a survival benefit for esophageal squamous cell carcinoma (ESCC). We evaluated the “upfront surgery and pathological stage-based adjuvant chemoradiation” strategy, in which adjuvant therapy is guided by pathological stage, in locally advanced ESCC. Data from 2976 clinical stage II/III ESCC patients, including 1735 in neoadjuvant chemoradiation and 1241 in upfront surgery groups, were obtained from a nationwide database. Patients in the upfront surgery group were further categorized into the “upfront surgery and pathological stage-based adjuvant chemoradiation” and “upfront surgery only” groups. The 3-year overall survival (OS) rates in the “neoadjuvant chemoradiation”, “upfront surgery and pathological stage-based adjuvant chemoradiation”, and “upfront surgery only” groups were 41.5%, 45.8%, and 28.5%, respectively. In propensity score matched patients, the 3-year OS rate was 41.7% in the neoadjuvant chemoradiation group, compared to 35.6% in the “upfront surgery and pathological stage-based adjuvant chemoradiation” group (p = 0.147), and 20.3% in the “upfront surgery only” group (p < 0.001). No survival difference was observed between the “neoadjuvant chemoradiation followed by surgery” protocol and the “upfront surgery and pathological stage-based adjuvant chemoradiation” strategy.

Copine�5 expression predicts prognosis following curative resection of esophageal squamous cell carcinoma

“…A primary goal of efforts to improve the management of the disease and patient outcomes is establishing methods to accurately predict the risk of recurrence, in addition to survival, following curative esophageal resection (3). Such information is urgently required to provide appropriate individualized perioperative follow-up and treatment (4,5). Furthermore, a better understanding of the molecular mechanisms of disease progression is essential, and identification of molecules that contribute to the pathogenesis of ESCC may lead to the development of novel biomarkers that facilitate precise risk stratification and monitoring of recurrence following esophagectomy (6,7).…”

Triple synchronous primary neoplasms in the gastrointestinal tract

“…Matsuda et al [ 2 ] reported no significant difference in overall five years survival between the neoadjuvant chemotherapy followed by surgery and upfront surgery ( P = 0.167). Chen et al [ 3 ] also found no survival difference between neoadjuvant chemoradiation followed by surgery and the upfront surgery with pathological stage-based adjuvant chemo-radiation ( P = 0.147).…”