305. SURVIVAL DIFFERENCES ACCORDING TO THE PATHOLOGIC STATUS AFTER NEOADJUVANT THERAPY FOLLOWED BY SURGERY IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA. (24th September 2022)

• Record Type: Journal Article
• Authors: Park, Seong Yong; Jeon, Yeong Jeong; Lee, Junghee; Ho, Jong; Choi, Yong Soo; Zo, Jae Il; Shim, Young Mog; Kim, Hong Kwan
• Is Part Of: Diseases of the esophagus. Volume 35(2022)Supplement 2
• Publication Date: 2022-09-24
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doac051.305
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: This retrospective study was performed to investigate the survival differences according to the pathologic status after neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery in esophageal squamous cell carcinoma (ESCC). The data of 507 patients who received the neoadjuvant CCRT and esophagectomy for ESCC between 2003 and 2018 were retrospectively reviewed. The mean age was 62.28 ± 8.07 and 473 (93.3%) were male patients. The median follow-up period was 29.24 months (interquartile range: 16.57–49.95 months). 144 (28.4%) patients showed pathologic complete response (ypCR) and 90 (17.8%) patients showed ypCR of primary lesion with residual metastatic lymph nodes (ypT0N+). 107 (33.5%) and 103 (20.3%) patients showed ypT + N+ and ypT + N0, respectively. In patients with residual metastatic lymph nodes, the numbers of metastatic lymph nodes were 1(112, 22.1%), 2(49, 9.7%) and more than 3(100, 19.7%). The 5-year overall survivals (OS) of each group were 71.1%(ypCR), 47.9%(ypT + N0), 51.8%(ypT0N+) and 27.1%(ypT + N+); ypCR patients showed better survival than others and there were no survival differences in 5-year OS between ypT + N0 and ypT0N+ patients (p = 0.811). ypT + N+ patients showed more common locoregional and distant metastasis. The 5-year freedom from distant metastasis were different according to pathologic status; 83.1%(ypCR), 69.4%(ypT + N0), 59.1%(ypT0N+) and 44.6%(ypT + N+). The numbers of residual metastatic lymph nodes were related to the distant metastasis (HR1.083, p < 0.001) ypCR offers long-term survival in patients without nodal metastases, but the survival significantly deteriorates with the presence of residual primary lesion and nodal metastases. Follow-up strategies and indication of additional postoperative therapy could be guided according to the pathologic status after neoadjuvant CCRT followed by surgery.