Pretreatment T3-4 Stage is an Adverse Prognostic Factor in Patients with Esophageal Squamous Cell Carcinoma Who Achieve Pathological Complete Response Following Preoperative Chemoradiotherapy

Abstract

We have shown that up to 31.4% of patients with esophageal SCC who achieve pCR develop tumor recurrence thereafter. Pretherapy T3-4 disease was a strong and independent adverse risk factor for 5-year tumor recurrence, DSS and DFS. High-risk patients with T3-4 disease should be followed with a strict surveillance protocol.

Perioperative Chemotherapy for Gastroesophageal Cancer in British Columbia: A Multicentre Experience

“…In the best-case scenario, preoperative treatment can induce a complete pathologic response, which is well known to be associated with improved outcomes in numerous malignancies, such as those of breast [29][30][31][32] , lung 33 , rectum 34 , and esophagus [35][36][37][38] . However, the prognostic value of a pathologic complete response after neoadjuvant treatment for gastric cancer is still a matter of debate 39 and deserves further analyses.…”

Prognostic significance of immunohistochemically detected lymph node micrometastases in pT0N0 esophageal squamous cell carcinoma

“…Approximately one-third of SCC patients with no evidence of residual tumor, and in the absence of risk factors, still developed recurrences. Studies have attempted to identify risk factors for recurrence and have mainly focusing on pretreatment clinical profiles [7]. To the best of our knowledge, the present study is the first to identify risk factors for recurrence after pCR by using IHC staining of resected specimens.…”

“…Despite no viable tumor being found on the resected esophagus and lymph node, one-third of these patients still develop recurrence [3,6]. Investigators have attempted to identify risk factors for recurrence, and studies have mainly focused on pretreatment clinical profiles [7].…”

Local Control May be the Key in Improving Treatment Outcomes of Esophageal Squamous Cell Carcinoma Undergoing Concurrent Chemoradiation

“…In RTOG 8501, the 5-year survival rate was significantly improved for patients treated with CCRT (26%) compared with those treated with radiation alone (0%). Other studies have shown that 17-51% of esophageal SCC patients achieve a complete response (CR) after CCRT [5,6,7]; however, 50% of these cases later develop cancer recurrence.…”

“…Thomas et al reported that 25% of patients assigned to multimodal therapy experienced a complete pathological response after resection and that 32% were alive after 3 years, whereas only 6% of patients treated with surgery alone lived for another 3 years [3]. The RTOG 8501 [4] randomized controlled trial and an Eastern Cooperative Oncology Group (ECOG) trial [5] showed that chemoradiation therapy (CCRT) without additional surgery is a curative option for patients with locally advanced esophageal cancer. In RTOG 8501, the 5-year survival rate was significantly improved for patients treated with CCRT (26%) compared with those treated with radiation alone (0%).…”