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Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer

PURPOSE: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT). MATERIALS AND METHODS: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradi...

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Autores principales: Kim, Yong-Hyub, Song, Sang-Yun, Shim, Hyun-Jeong, Chung, Woong-Ki, Ahn, Sung-Ja, Yoon, Mee Sun, Jeong, Jae-Uk, Song, Ju-Young, Nam, Taek-Keun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Radiation Oncology 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394064/
https://www.ncbi.nlm.nih.gov/pubmed/25874173
http://dx.doi.org/10.3857/roj.2015.33.1.12
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author Kim, Yong-Hyub
Song, Sang-Yun
Shim, Hyun-Jeong
Chung, Woong-Ki
Ahn, Sung-Ja
Yoon, Mee Sun
Jeong, Jae-Uk
Song, Ju-Young
Nam, Taek-Keun
author_facet Kim, Yong-Hyub
Song, Sang-Yun
Shim, Hyun-Jeong
Chung, Woong-Ki
Ahn, Sung-Ja
Yoon, Mee Sun
Jeong, Jae-Uk
Song, Ju-Young
Nam, Taek-Keun
author_sort Kim, Yong-Hyub
collection PubMed
description PURPOSE: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT). MATERIALS AND METHODS: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). RESULTS: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. CONCLUSION: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.
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spelling pubmed-43940642015-04-14 Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer Kim, Yong-Hyub Song, Sang-Yun Shim, Hyun-Jeong Chung, Woong-Ki Ahn, Sung-Ja Yoon, Mee Sun Jeong, Jae-Uk Song, Ju-Young Nam, Taek-Keun Radiat Oncol J Original Article PURPOSE: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT). MATERIALS AND METHODS: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). RESULTS: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. CONCLUSION: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT. The Korean Society for Radiation Oncology 2015-03 2015-03-31 /pmc/articles/PMC4394064/ /pubmed/25874173 http://dx.doi.org/10.3857/roj.2015.33.1.12 Text en Copyright © 2015. The Korean Society for Radiation Oncology http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Yong-Hyub
Song, Sang-Yun
Shim, Hyun-Jeong
Chung, Woong-Ki
Ahn, Sung-Ja
Yoon, Mee Sun
Jeong, Jae-Uk
Song, Ju-Young
Nam, Taek-Keun
Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
title Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
title_full Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
title_fullStr Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
title_full_unstemmed Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
title_short Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
title_sort treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394064/
https://www.ncbi.nlm.nih.gov/pubmed/25874173
http://dx.doi.org/10.3857/roj.2015.33.1.12
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