EVALUATION OF NEOADJUVANT CHEMORADIOTHERAPY IN CLINICAL STAGE II AND III ESOPHAGEAL SQUAMOUS CELL CARCINOMA IN A REGIONAL CENTER HOSPITAL

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  • 地域中核一般病院におけるＳｔａｇｅ　ＩＩ・ＩＩＩ食道癌に対する術前化学放射線治療の評価

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Abstract

[Background] We evaluated the treatment strategy of neoadjuvant chemoradiotherapy followed by curative surgery combined with 2-field lymph node dissection for clinical stage IIand III esophageal squamous cell carcinoma (ESCC) in our regional center hospital.<br>[Patients & Methods] 46 patients with clinical stage II and III ESCC who underwent surgery at our department were enrolled. Among those 34 patients received neoadjuvant chemoradiotherapy (nCRT+S group), and 12 did not (S group). Clinicopathological parameters, prognosis recurrence site and postoperative morbidity were evaluated.<br>[Results] 1-, 3- and 5-year survival rates of 46 patients were 79.7, 31.2, and 31.2%, respectively. Five-year survival rates of nCRT+S and S groups were 34.8% amd 16.9%, respectively (p=0.80). Multivariate analysis revealed that pathological stage (pStage) was an independent prognostic factor. Among 34 patients in nCRT+S group, clinicopathological characteristics of pStage 0+I+II patients were significantly superior to those of pStage III+IVa patients with respect to venous infiltration (v factor) and CRT Grade, and they showed a significant down staging. In-hospital death was zero and the postoperative morbidity rate was 17.6% in nCRT+S group.<br>[Conclusions] Our treatment strategy for clinical stage II and III ESCC, neoadjuvant chemoradiotherapy followed by curative surgery combined with 2-field lymph node dissection, proved acceptable. It is necessary, however to develop an effective treatment strategy for patients with pStage III+IVa ESCC after surgery.

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