Survival outcomes of resected patients who demonstrate a pathologic complete response after neoadjuvant chemoradiation therapy for locally advanced esophageal cancer

Zane T. Hammoud, K. A. Kesler, M. K. Ferguson, R. J. Battafarrano, A. Bhogaraju, N. Hanna, R. Govindan, A. A. Mauer, M. Yu, L. H. Einhorn

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

A variety of strategies, using chemotherapy, radiation therapy, and surgical resection have been employed in the treatment of locally advanced esophageal cancer. No strategy has proven superior, and poor long-term survival is anticipated. A survival benefit has been suggested for patients who achieve a pathologic complete response (pCR) following neoadjuvant chemoradiation therapy. We examined the collective results at three institutions of patients who achieved a pCR following neoadjuvant chemoradiation therapy. A retrospective, chart-based review was conducted. Kaplan-Meier calculations were used to determine overall and disease-free survival. Between 1995 and 2002, 229 patients were treated with neoadjuvant chemoradiation followed by surgery as a planned approach for locally advanced esophageal cancer. Forty-one patients (18%) demonstrated pCR and were the focus of this study. Histology was adenocarcinoma in 29, squamous in 10, and adenosquamous/undifferentiated in two patients. Forty patients were staged by endoscopic ultrasound prior to neoadjuvant therapy and all demonstrated a T-stage of 2 or higher, while 19 had evidence of nodal metastasis. Four patients died in the perioperative period. The remaining patients have been followed for an average of 46 months. Overall survival at 5 years was 56.4% and a median survival has not been reached. Esophageal cancer patients who demonstrate a pCR following neoadjuvant chemoradiation are a select subset who demonstrate excellent long-term survival. Identification of clinical variables or biomarkers predictive of pCR may therefore optimize treatment strategies of patients with locally advanced esophageal cancer.

Original languageEnglish (US)
Pages (from-to)69-72
Number of pages4
JournalDiseases of the Esophagus
Volume19
Issue number2
DOIs
StatePublished - Apr 1 2006

Keywords

  • Esophageal cancer
  • Esophagectomy
  • Neoadjuvant therapy
  • Pathologic complete response
  • Survival

ASJC Scopus subject areas

  • Gastroenterology

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