306. THE ROLE OF ADJUVANT CHEMOTHERAPY AFTER NEOADJUVANT THERAPY FOLLOWED BY SURGERY IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract

Abstract This retrospective study was performed to investigate the efficacy of adjuvant chemotherapy after neoadjuvant therapy followed by surgery in esophageal squamous cell carcinoma (ESCC). The data of 428 patients who received the neoadjuvant therapy and esophagectomy for ESCC between 2003 and 2018 were retrospectively reviewed. The 1:2 propensity score matching was performed to balance the patients’ characteristics. Eighty-three (19.4%) patients received the adjuvant chemotherapy, whereas 345 (80.6%) did not receive the adjuvant chemotherapy. The median follow-up period was 27.04 months (interquartile range: 15.85–62.04 months). The patients who received the adjuvant chemotherapy showed better pulmonary function and ASA score, but there were no differences after propensity score matching. In matched patients, the adjuvant chemotherapy did not improve the OS, but subgroup analysis revealed that 5-year OS improved in ypT + N+ patients by adjuvant chemotherapy (20.2% vs. 27.7%, p = 0.012), whereas the benefit of adjuvant chemotherapy was no observed in ypT0N0, ypT + N0 and ypT0N+. Multivariable analysis showed that ypStage, ASA score and adjuvant chemotherapy (HR 0.462, p = 0.004) was associated with OS in ypT + N+ patients. The freedom from distant metastasis was significantly different according to the adjuvant chemotherapy (27.2% vs. 49.5%, p = 0.039). Adjuvant chemotherapy after neoadjuvant therapy followed by surgery in ypT + N+ ESCC patients might improve the OS by reducing the distant metastasis. The consideration could be given to administration of adjuvant chemotherapy to ypT + N+ ESCC patients with tolerable conditions.