Failure mode and long-term survival after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma
10.3760/cma.j.cn113030-20220812-00277
- VernacularTitle:局部晚期食管鳞癌新辅助治疗后失败模式及长期生存分析
- Author:
Ruiqi WANG
1
;
Lin WANG
;
Xiao HU
;
Honglian MA
;
Guoqin QIU
;
Zhun WANG
;
Xiaojiang SUN
;
Yongling JI
;
Xiaojing LAI
;
Wei FENG
;
Liming SHENG
;
Yuezhen WANG
;
Xia ZHOU
;
Youhua JIANG
;
Changchun WANG
;
Qiang ZHAO
;
Xun YANG
;
Jinshi LIU
;
Jian ZENG
;
Haitao JIANG
;
Pu LI
;
Xianghui DU
;
Qixun CHEN
;
Yujin XU
Author Information
1. 中国科学院大学附属肿瘤医院（浙江省肿瘤医院）胸部放疗科，浙江省放射肿瘤学重点实验室，中国科学院基础医学与肿瘤研究所，杭州 310022
- Keywords:
Esophageal neoplasms;
Neoadjuvant chemoradiotherapy;
Survival analysis;
Pathological complete response
- From:
Chinese Journal of Radiation Oncology
2023;32(4):301-306
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.
