289. RISK FACTOR OF RELAPSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA WHO ACHIEVE PATHOLOGIC COMPLETE RESPONSE TO NEOADJUVANT CHEMORADIOTHERAPY

Abstract

Abstract Background Controversy still exists as to the risk factors of recurrence in patients with esophageal squamous cell carcinoma (ESCC) who achieve pathologic complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) plus esophagectomy. This study aimed to investigate the patterns and risk factors for recurrence in ESCC patients with pCR after nCRT in a single center. Method Between January 2008 and December 2018 a total of 96 ESCC cases with pCR were enrolled in this study. Sterilized lymph nodes (SLN) were defined as those lymph nodes without residual tumor but with the presence of treatment response to nCRT. Recurrence patterns were investigated and then prognostic factors for recurrence-free survival (RFS) were analyzed with univariate and multivariate analyses. Results The median follow-up time was 51.5 months. Recurrence occurred in 15 cases (15.6%) with a 9.9 months median time to recurrence and a 15.6 months median survival after recurrence. The most majority of recurrent diseases developed within the first 2 years after surgery. Distant recurrences were detected in 14 cases (14.6%), in which the most common recurrence sites were supraclavicular lymph nodes and lung, followed by para-aortic lymph nodes. The mean RFS in the whole cohort was 116.6 months. Positive SLN was identified as the independently prognostic factor for worse RFS in the multivariate analysis (HR: 5.93, 95%CI: 2.09–16.86, P = 0.001). Conclusion Relapse is not rare in ESCC cases with pCR after nCRT. Distant recurrences, the predominant pattern of relapse, mostly occur with the first 2 years after esophagectomy. pCR patients with positive SLN have a higher risk for postoperative recurrence.