The prognostic value of residual nodal disease following neoadjuvant chemoradiation for esophageal cancer in patients with complete primary tumor response. Issue 6 (23rd September 2015)

• Record Type: Journal Article
• Authors: Blackham, Aaron U.; Yue, Binglin; Almhanna, Khaldoun; Saeed, Nadia; Fontaine, Jacques P.; Hoffe, Sarah; Shridhar, Ravi; Frakes, Jessica; Coppola, Domenico; Pimiento, Jose M.
• Is Part Of: Journal of surgical oncology. Volume 112:Issue 6(2015:Nov. 01)
• Page Start: 597
• Page End: 602
• Publication Date: 2015-09-23
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24050
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso24050-sec-0001" sec-type="section"> <title>Background</title> <p>The prognostic significance of residual nodal disease in otherwise complete pathologic responders (ypT0N+) to neoadjuvant chemoradiation (nCRT) for esophageal cancer is unknown.</p> </sec> <sec id="jso24050-sec-0002" sec-type="section"> <title>Methods</title> <p>ypT0N+ responders were identified from a single institution database of esophageal cancer patients undergoing esophagectomy and were compared to patients without locoregional disease (ypT0N0) and to non‐complete responders (ypT+).</p> </sec> <sec id="jso24050-sec-0003" sec-type="section"> <title>Results</title> <p>Out of 487 patients, 196 ypT0N0 and 14 ypT0N+ patients were identified. Pre‐treatment stage was similar between ypT0N0 and ypT0N+ patients: 66% versus 73% of patients had uT3 disease (<italic>P </italic>= 0.50) and 76% versus 55% had nodal involvement (<italic>P </italic>= 0.49), respectively. Locoregional recurrence (43%) was more common in ypT0N+ patients. Median overall survival (OS) was worse in ypT0N+ patients (14.8 months) compared to ypT0N0 patients (92.2 months) and ypT+ patients (38.0 months, <italic>P</italic> < 0.001). Median OS of ypT0N+ patients was similar to ypT+ stage II (29.6 months, <italic>P </italic>= 0.84) and stage III (27.5 months, <italic>P </italic>= 0.95) disease. No difference in median OS existed in patients with residual nodal disease (n = 163) based on local response (14.8 months in ypT0N+ and 22.5 months in ypT+N+ patients, <italic>P </italic>= 0.55).</p> </sec> <sec id="jso24050-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Residual nodal disease in esophageal cancer patients with complete response in the primary tumor following nCRT portends a poor prognosis and behaves similar to pathologic stage II/III disease. <italic>J. Surg. Oncol. 2015;112:597–602</italic>. © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>