Postchemoradiotherapy (CRT) pathologic stage classified by American Joint Committee on Cancer (AJCC) staging system to predict prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC).

Abstract

158 Background: Preoperative CRT followed by surgery is a curative treatment option for patients with locally advanced ESCC. Whether post-CRT pathologic staging can predict the outcomes of these patients is uncertain. Methods: Among 194 patients enrolled in three phase II clinical trials of preoperative CRT for patients with locally advanced ESCC (clinical T3N0-1M0 or T1-3N1M0 or M1a according to AJCC 6th edition), 140 patients were included. All patients received preoperative CRT comprised with twice weekly paclitaxel/cisplatin-based regimens and radiotherapy 40Gy given in 20 fractions, and esophagectomy. Post-CRT pathologic staging was classified according to AJCC 7thedition. Clinicopathologic factors were analyzed for their impacts on patients' overall survival (OS) and progression-free survival (PFS). Results: One hundred and thirty two men and 8 women were enrolled. The distribution of the post-CRT pathologic stages according to AJCC 7thedition and their median survival times were listed in Table 1. In univariate analysis, gender, performance status (PS), tumor location, pathologic N, pathologic stage, extranodal extension (ENE), and pathologic complete response (pCR) were statistically significant factors associated with PFS; PS, tumor location, pathologic N, pathologic stage, ENE, and pCR were statistically significant factors associated with OS. In multivariate analysis, PS (P < 0.001), tumor location (P = 0.016), and ENE (P = 0.024) were independent prognostic factors for PFS; PS (P < 0.001) and post-CRT pathologic stage (P = 0.027) were independent prognostic factors for OS. Conclusions: Post-CRT pathologic staging classified by AJCC 7thedition could predict the survivals of patients with locally advanced ESCC who underwent preoperative paclitaxel/cisplatin-based CRT followed by esophagectomy. (The work was supported by the Grant of MOST 103-2314-B-002-092.) [Table: see text]