PS02.113: NEOADJUVANT CHEMORADIOTHERAPY FOLLOWED BY ESOPHAGECTOMY FOR LOCALLY BORDERLINE RESECTABLE THORACIC ESOPHAGEAL CANCER

Abstract

Abstract Background Nowadays, it has emerged that conventional neoadjuvant chemotherapy for locally borderline resectable esophageal cancer is not effective. However, it still remains controversial which treatment is best. We aimed to evaluate neoadjuvant chemoradiotherapy for locally borderline resectable esophageal cancer. Methods Twenty six patients (23 men, 3 women) who underwent esophagectomy after neoadjuvant chemoradiotherapy between January 2011 and December 2016 were subjected. Radiotherapy was administered at 40 Gy with concurrent chemotherapy which consisted of 5-fluorouracil and cisplatin for all 26 patients. The therapeutic effect of neoadjuvant chemoradiotherapy and surgical outcomes including rates of curative resection and pathological complete response, and postoperative complications were retrospectively reviewed. Postoperative complications were defined as any event requiring specific medical or surgical treatment, which were assessed by the Clavien-Dindo classification. The evaluation criteria of neoadjuvant chemoradiotherapy were assessed by the RECIST guideline (ver.1.1). Results For primary tumor, 24 patients showed partial response and 2 showed stable disease. Therefore, the response rate to the primary tumor was 92.3%. For metastatic lymph nodes, on the other hand, 11 patients showed partial response and 8 showed stable disease and 1 showed progressive disease, and the response rate was 55%. Two patients were unresectable, three patients had R2 resection, and the remaining 21 patients (81%) had curative resection (R0). In the R0 resected group, the 5-year survival rate was 57%. The median operative time, bleed loss, and postoperative hospital stays were 546 minutes (178–963), 720ml (262–5170) and 34days (17–99), respectively. Postoperative complications were observed in 22 patients. The incidences of more than grade2 postoperative pneumonia, vocal cord palsy, and anastomosis leakage were 8/26 (31%), 8/26 (31%) and 3/26 (12%). There were treatment-related mortality in 2 patients. Seven patients (27%) achieved histologically complete response. Conclusion Neoadjuvant chemoradiotherapy for locally borderline resectable esophageal cancer is effective in increasing curative resection rate. In addition, patients who underwent curative resection can expect long-term survival. Disclosure All authors have declared no conflicts of interest.