PS02.109: CLINICAL SIGNIFICANCE OF NEOADJUVANT CHEMOTHERAPY IN ESOPHAGEAL CANCER PATIENTS WITH SEVERE DYSPHAGIA

Abstract

Abstract Background Neoadjuvant chemotherapy (NAC) followed by curative resection is a standard treatment for resectable locally advanced esophageal cancer. However, clinical significance of NAC for patients with severe dysphasia due to esophageal stenosis was not fully validated. Methods Fifty patients with resectable locally advanced esophageal cancer who received cisplatin and 5-fluorouracil followed by curative resection between 2006 and 2005 in our institution were retrospectively reviewed. Twenty-one patients required nutritional support due to severe dysphasia before or during NAC (Group A) and the remaining 29 patients had no dysphagia (Group B). Clinicopathological characteristics, nutritional status, treatment-related adverse events, and survival were compared between the two groups. Results Seventeen patients received enteral feeding with transnasal tube and the remaining 4 patients (19%) received parenteral nutrition alone in group A. There were no significant differences in tumor characteristics between the two groups. Serum albumin levels of group A and B before NAC were 3.8 and 4.3 g/dL (P = 0.02), and those after NAC were 3.6 and 4.0 g/dL, respectively (P < 0.01). NAC completion rates of group A and B were 86% and 83% (P = 0.78) and grade 3 or higher leukocytopenia developed in 33% and 10%, respectively (P = 0.07). Postoperative pneumonia of grade 2 or higher according to the Clavien-Dindo classification occurred in 48% and 28%, respectively (P = 0.23). Five-year overall survival rates of group A and B were 45% and 71%, respectively (P = 0.04). Conclusion NAC could be safely completed in patients with severe dysphagia; however, those were likely to have treatment-related adverse events and poorer survival. Disclosure All authors have declared no conflicts of interest.