Verification of the Optimal Interval Before Esophagectomy After Preoperative Neoadjuvant Chemoradiotherapy for Locally A

  • PDF / 317,993 Bytes
  • 10 Pages / 595.276 x 790.866 pts Page_size
  • 57 Downloads / 150 Views

DOWNLOAD

REPORT


ORIGINAL ARTICLE – THORACIC ONCOLOGY

Verification of the Optimal Interval Before Esophagectomy After Preoperative Neoadjuvant Chemoradiotherapy for Locally Advanced Thoracic Esophageal Cancer Akiyuki Wakita, MD, PhD, Satoru Motoyama, MD, PhD, Yusuke Sato, MD, PhD, Yushi Nagaki, MD, Hiromu Fujita, MD, Kaori Terata, MD, PhD, Kazuhiro Imai, MD, PhD, and Yoshihiro Minamiya, MD, PhD Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan

ABSTRACT Background. The interval between preoperative chemoradiotherapy and surgery reportedly affects perioperative outcomes and survival; however, the optimal interval in esophageal cancer patients remains uncertain. Objective. Our aim was to determine whether a prolonged interval between preoperative neoadjuvant chemoradiotherapy (NACRT) and esophagectomy affects the outcomes of esophageal cancer patients. Methods. A total of 131 patients with esophageal cancer received curative surgery following NACRT at Akita University Hospital between 2009 and 2017. We divided these patients into two groups based on the median interval from NACRT to esophagectomy, and compared the rates of pathological complete response (pCR), surgical outcomes, and survival. Results. The median interval from NACRT to esophagectomy was 39 days (range 21–95). Of the 131 patients, 70 (53%) received esophagectomy after 39 days or more from completion of NACRT. There were no significant differences in the clinicopathological features, including pCR rates, between the two groups. Prolongation of the interval from NACRT to esophagectomy was significantly associated with an increased rate of anastomotic leakage and recurrent laryngeal nerve palsy (p = 0.0225 and p = 0.0022, respectively); however, no association with overall survival was detected.

Ó Society of Surgical Oncology 2020 First Received: 29 February 2020 Accepted: 24 September 2020 A. Wakita, MD, PhD e-mail: [email protected]

Conclusions. A prolonged interval between NACRT and esophagectomy had no impact on pCR rates or survival. However, delaying esophagectomy may increase the likelihood of surgical complications such as anastomotic leakage and recurrent laryngeal nerve palsy.

Thoracic esophageal cancer is a highly aggressive cancer that has a rapid clinical course and a poor 5-year survival rate for locally advanced cancer.1–3 Nonetheless, recent advances in multidisciplinary treatment have improved outcomes for thoracic esophageal cancer patients.4 Thoracic esophageal squamous cell carcinoma (TESCC), for example, is known to be susceptible to both chemotherapy and radiotherapy and further benefit is gained by using the two in combination.5,6 For that reason, in Europe, the US, and parts of Asia, preoperative neoadjuvant chemoradiotherapy (NACRT) is the standard treatment for TESCC.7–11 In Japan, neoadjuvant chemotherapy (NAC) with cisplatin and 5-fluorouracil became the standard treatment for cStage II–III TESCC, based on the results of clinical trials by the Japan Clinical Oncology Group (JCOG) in which NAC

Data Loading...

Recommend Documents