Does postoperative treatment bring survival benefits to patients with locally advanced esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen?_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HUANG Zekai ¹ , LI Shaolei ¹ , LU Fangliang ¹ , YAN Shi ¹ , YANG Xin ² , MA Yuanyuan ¹ ,  YANG Yue ¹

1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery Ⅱ, Peking University Cancer Hospital and Institute, Beijing, 100142, P.R.China;
2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital and Institute, Beijing, 100142, P.R.China;

Corresponding author：

YANG Yue, Email: zlyangyue@bjmu.edu.cn

Keywords：

Locally advanced stage; esophageal squamous cell carcinoma; neoadjuvant chemotherapy; TP regimen

DOI：

10.7507/1007-4848.201808040

Video：

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Objective To investigate whether postoperative therapy can bring survival benefits to patients with locally advanced esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen. Methods We retrospectively reviewed clinical data of 115 patients with locally advanced esophageal squamous cell carcinoma who received neoadjuvant chemotherapy with TP regimen and underwent esophagectomy in our hospital from January 2007 through December 2016. Patients were divided into two groups including a non-receiving treatment group (54 patients with 47 males and 7 females) and a receiving treatment group (61 patients with 52 males and 9 females). There were 31 patients with postoperative chemotherapy, 14 with postoperative radiotherapy, and 16 with postoperative chemotherapy and radiotherapy in the receiving treatment group. Results In the non-receiving treatment group, the 5-year median disease free survival (DFS) rate was 54.7%, and the 5-year overall survival (OS) rate was 55.3%. In the receiving treatment group, the median DFS was 46.0 months (95% CI 22.9–69.1), the 5-year DFS rate was 42.3%; and the median OS was 68.0 months (95% CI 33.0–103.0), the 5-year OS rate was 51.3%. Furthermore, there was no statistical difference between the two groups with regards to DFS (P=0.641) or OS (P=0.757) using Kaplan-Meier method. Besides, in each subgroup, the results of Cox proportional hazard model analysis showed postoperative treatment did not improve survival (P>0.05, respectively). Conclusion Postoperative treatment does not bring survival benefits to patients with esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen.

Citation： HUANG Zekai, LI Shaolei, LU Fangliang, YAN Shi, YANG Xin, MA Yuanyuan, YANG Yue. Does postoperative treatment bring survival benefits to patients with locally advanced esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen?. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(5): 413-418. doi: 10.7507/1007-4848.201808040 Copy

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18.	Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med, 2006, 355(1): 11-20.
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1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
4. Medical Research Council Oesophageal Cancer Working Group. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet (London, England), 2002, 359(9319): 1727-33.
5. Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. Send to J Clin Onco, 2009, 27(30): 5062-5067.
6. Boonstra JJ, Kok TC, Wijnhoven BP, et al. Chemotherapy followed by surgery versus surgery alone in patients with resectable oesophageal squamous cell carcinoma: long-term results of a randomized controlled trial. BMC cancer, 2011, 11: 181.
7. Ilson DH, Ajani J, Bhalla K, et al. Phase Ⅱ trial of paclitaxel, fluorouracil, and cisplatin in patients with advanced carcinoma of the esophagus. J Clin Oncol, 1998, 16(5): 1826-1834.
8. Petrasch S1, Welt A, Reinacher A, et al. Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer. Br J Cancer, 1998, 78(4): 511-514.
9. Ilson DH, Forastiere A, Arquette M, et al. A phase Ⅱ trial of paclitaxel and cisplatin in patients with advanced carcinoma of the esophagus. Cancer J, 2000, 6(5): 316-323.
10. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med, 2001, 345(10): 725-730.
11. Saeed NA, Mellon EA, Meredith KL, et al. Adjuvant chemotherapy and outcomes in esophageal carcinoma. J Gastrointest Oncol, 2017, 8(5): 816-824.
12. Saunders JH, Bowman CR, Reece-Smith AM, et al. The role of adjuvant platinum-based chemotherapy in esophagogastric cancer patients who received neoadjuvant chemotherapy prior to definitive surgery. J Surg Oncol, 2017, 115(7): 821-829.
13. Brescia AA, Broderick SR, Crabtree TD, et al. Adjuvant therapy for positive nodes after induction therapy and resection of esophageal cancer. Ann Thorac Surg, 2016, 101(1): 200-208.
14. Rice TW, Ishwaran H, Ferguson MK, et al. Cancer of the esophagus and esophagogastric junction: an eighth edition staging primer. J Thorac Oncol, 2017, 12(1): 36-42.
15. 张思维, 郑荣寿, 左婷婷, 等. 中国食管癌死亡状况和生存分析. 中华肿瘤杂志, 2016, 38(9): 709-715.
16. van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med, 2012, 366(22): 2074-2084.
17. Yang H, Liu H, Chen Y, et al. Neoadjuvant chemoradiotherapy followed by surgery versus surgery alone for locally advanced squamous cell carcinoma of the esophagus (neocrtec5010): a phase iii multicenter, randomized, open-label clinical trial. J Clin Oncol, 2018, 36(27): 2796-2803.
18. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med, 2006, 355(1): 11-20.
19. Ychou M, Boige V, Pignon JP, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase Ⅲ trial. J Clin Oncol, 2011, 29(13): 1715-1721.
20. Smalley SR1, Benedetti JK, Haller DG, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase Ⅲ trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Onco, 2012, 30(19): 2327-2333.
21. Network NCC. Esophageal and Esophagogastric Junction Cancers (Version 1.2018)[M].

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Does postoperative treatment bring survival benefits to patients with locally advanced esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen?

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