Effect of Time to Minimally Invasive Esophagectomy After Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

Autor: Nguyen Vo Vinh Loc, Nguyen Lam Vuong, Lam Viet Trung, Tran Thien Trung
Rok vydání: 2023
Předmět:
Zdroj: Journal of Gastrointestinal Cancer.
ISSN: 1941-6636
1941-6628
DOI: 10.1007/s12029-023-00915-6
Popis: Background: Neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and 5-fluorouracil/capecitabine (DCF/DCX) followed by esophagectomy has been the recommended treatment for esophageal squamous cell carcinoma (ESCC). However, the optimal interval from NAC to surgery has not yet been established. This study evaluated the impact of time to surgery (TTS) in the treatment of ESCC. Methods: Between August 2018 and September 2021, 97 patients who underwent radical esophagectomy following 3-6 cycles of NAC with DCF/DCX for ESCC at a single hospital were analyzed. TTS was categorized into three groups: 16-41 days (group 1; 33 patients), 42-55 days (group 2; 29 patients), and 56-135 days (group 3; 35 patients). Survival outcomes included overall survival (OS) and progression-free survival (PFS). Results:Mean age was 59.6±6.8 years, and 95 patients were male. One patient had grade-3 anemia, 12 had grade-2 anemia, and four had grade-2 neutropenia; all other NAC-related toxicities were as grade 1. Regarding pathologic tumor response, 18.6% achieved complete response, 71.1% achieved partial response, and 10.3% had stable disease. Forty-eight patients (49.5%) had a postoperative complication, but only six (6.2%) with grade-IIIa and two (2.1%) with grade IV-a according to the Clavien-Dindo classification. Median follow-up time was 24 months. Group 1 and 3 had worse OS (HR [95% CI]: 3.36 [1.16-11.7] and 1.83 [0.55-6.10]) and worse PFS (HR [95% CI]: 3.27 [1.25-8.53] and 1.61 [0.58-4.45]) compared to group 2. Conclusion: The optimal TTS after NAC could be 6-8 weeks. The surgery should not be performed too early.
Databáze: OpenAIRE
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