Evaluation of prognostic factors after esophagectomy in which preoperative chemotherapy was successful.

Abstract

e15568 Background: Current standard treatment for Stage IB/II/III Japanese squamous cell carcinoma of the esophagus is esophagectomy after two courses preoperative chemotherapy with 5-FU/CDDP. Prognosis of cases in which preoperative chemotherapy was successful is usually good, but some cases were recurrence. On the other hand, some reports showed that the negative survival impact of infectious complications after esophagectomy is canceled out by succeeding preoperative chemotherapy. So we evaluate of prognostic factors after esophagectomy in which preoperative chemotherapy was successful. Methods: Between 2011 and 2015, 122 cases were performed esophagectomy after two courses of preoperative chemotherapy using 5-FU/CDDP for stage IB / II / III esophageal cancer, and 46 cases were achieved Grade 2 histopathological effect(2/3 or more disappearance of tumor). We examined 3-year survival rate and 3-year RFS in this 46 cases and examined what could be a prognostic factor. PS, ASA, sex, operation time, volume of bleeding , postoperative complications(C-D classification≧G2), pT, pN, tumor wall retentivity, preoperative nutritional status(Albumin, CRP, Prealbumin, RBP), nutritional indicators at discharge (weight change rate, fat mass change rate, muscle mass change rate) were evaluated as recurrence prediction factor. Results: 3-year OS of histological Grade2 cases were 84.5%, and 3 -year RFS were 88.8%. In 46 cases, relapse was found in 12 cases, and univariate analysis showed pT, pN as a risk of relapse, and multivariate analysis showed only pT as a risk of relapse. There were 5 cases of recurrence within 1 year after esophagectomy, and there was a significantly poor prognosis compared with recurrent cases later than 1 year after esophagectomy. Conclusions: The risk factor of recurrence in patients with squamous cell carcinoma after preoperative chemotherapy followed by esophagectomy was pathological T factor, and recurrent case within 1 year after esophagectomy was significantly poor prognosis.