PATHOLOGIC COMPLETE RESPONSE (YPT0 YPN0) AFTER CHEMOTHERAPY AND RADIOTHERAPY NEOADJUVANT FOLLOWED BY ESOPHAGECTOMY IN THE SQUAMOUS CELL CARCINOMA OF THE ESOPHAGUS
| Autor: | Giovanni de Carvalho Beraldo, Luiz Roberto Lopes, Valdir Tercioti-Junior, João de Souza Coelho-Neto, José Antonio Possato Ferrer, Nelson Adami Andreollo, Iuri Pedreira Filardi Alves |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors Esophageal Neoplasms medicine.medical_treatment RC799-869 0302 clinical medicine Esofagectomia Neoadjuvant therapy Medical record Chemoradiotherapy General Medicine Middle Aged Diseases of the digestive system. Gastroenterology Treatment Outcome medicine.anatomical_structure Esophagectomy 030220 oncology & carcinogenesis Female Original Article 030211 gastroenterology & hepatology Esophageal Squamous Cell Carcinoma Radiology Terapêutica neoadjuvante Adult medicine.medical_specialty RD1-811 Antineoplastic Agents Disease-Free Survival 03 medical and health sciences Radioterapia medicine Humans Chemotherapy Esophagus Survival analysis Aged Retrospective Studies Analysis of Variance Radiotherapy business.industry Retrospective cohort study Radiation therapy Esophageal carcinoma Carcinoma do esôfago Surgery Quimioterapia Cisplatin business |
| Zdroj: | ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), Volume: 31, Issue: 4, Article number: e1405, Published: 06 DEC 2018 ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.31 n.4 2018 ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) Colégio Brasileiro de Cirurgia Digestiva (CBCD) instacron:CBCD ABCD: Arquivos Brasileiros de Cirurgia Digestiva, Vol 31, Iss 4 (2018) Arquivos Brasileiros de Cirurgia Digestiva : ABCD |
| Popis: | Background: Esophageal squamous cell carcinoma is an aggressive neoplasia that requires a multidisciplinary treatment in which survival and prognosis are still not satisfactory. The complete pathologic response to neoadjuvant chemotherapy and radiotherapy is considered a good prognosis factor, and esophagectomy is indicated. Aim: Survival analysis of cases with pathologic complete response (ypT0 ypN0) to neoadjuvant chemotherapy and/or radiotherapy, submmitted to esophagectomy. Methods: Between 1983-2014, 222 esophagectomies were performed, and 177 were conducted to neoadjuvant treatment. In 34 patients the pathologic response was considered complete. Medical records of the patients were retrospectively reviewed regarding type of chemotherapy applied, amount of radiotherapy, interval between the neoadjuvant therapy and the surgery, body mass index; postoperative complications; hospital admission time and survival. Results: The average age was 55.8 years. Twenty-five patients were subjected to chemotherapy and radiotherapy, and nine to neoadjuvant radiotherapy. The total radiation dose ranged from 4400 until 5400 cGy. The chemotherapy was performed with 5FU, cisplatin, and carbotaxol, concomitantly with the radiotherapy. The esophagectomy was transmediastinal, followed by the cervical esophagogastroplasty performed on a average of 49.4 days after the neoadjuvant therapy. The hospital admission time was an average of 14.8 days. During the follow-up period, 52% of the patients submitted to radiotherapy and chemotherapy were disease-free, with 23.6% of them presenting more than five years survival. Conclusions: The neoadjuvant treatment followed by esophagectomy in patients with pathologic complete response is beneficial for the survival of patients with esophageal squamous cell carcinoma. RESUMO Racional: O carcinoma epidermoide do esôfago é neoplasia de natureza agressiva, que requer tratamento multidisciplinar e tem taxas de sobrevida e prognóstico ainda não satisfatórios. A resposta patológica completa à neoadjuvância com quimioterapia e radioterapia é considerada fator de bom prognóstico e a esofagectomia está indicada. Objetivo: Análise de sobrevida dos casos com resposta patológica completa (ypT0 ypN0) à neoadjuvância com quimioterapia e/ou radioterapia, submetidos à esofagectomia. Métodos: Entre 1983-2014, 222 esofagectomias foram realizadas e 177 foram submetidas ao tratamento neoadjuvante. Em 34 pacientes, a resposta patológica foi considerada completa. Os prontuários dos pacientes foram revisados retrospectivamente quanto ao tipo de quimioterapia aplicada, quantidade de radioterapia, intervalo entre a terapia neoadjuvante e a operação, índice de massa corporal (IMC), complicações pós-operatórias, tempo de internação hospitalar e sobrevida. Resultados: A idade média foi de 55,8 anos. Vinte e cinco pacientes foram submetidos a quimioterapia e radioterapia e nove à radioterapia neoadjuvante. A dose total de radiação variou de 4400 até 5400 cGy. A quimioterapia foi realizada com 5FU, cisplatina e carbotaxol, concomitantemente à radioterapia. A esofagectomia foi transmediastinal, seguida da esofagogastroplastia cervical realizada em média 49,4 dias após a terapia neoadjuvante. O tempo de internação hospitalar foi em média de 14,8 dias. Durante o período de seguimento, 52% dos pacientes submetidos a radioterapia e quimioterapia estavam livres de doença, com 23,6% apresentando sobrevida maior que cinco anos. Conclusão: O tratamento neoadjuvante seguido de esofagectomia, nos pacientes com resposta patológica completa, oferece benefícios na sobrevida de portadores de carcinoma epidermoide do esôfago. |
| Databáze: | OpenAIRE |
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