BACKGROUND/AIMS: MuItimodality treatment improves esophageal squamous cell carcinoma (ESCC) prognosis, however the most optimal treatment still remains controversial. METHODOLOGY: In 213 ESCC patients who had operation at Kitasato University Hospital between 1996 and 2007, prognosis was evaluated in terms of cStage and adjuvant therapy. RESULTS: Survival outcome of with the 62 cStage I ESCC were excellent (2 recurrences) with infrequent postoperative treatment (Adj). Of 129 ESCC patients with cStage II/III, 45 patients including suspicious cT4 (cT3.5) were given neoadjuvant therapy (Neo), and pStage 0/I patients showed excellent prognosis. Of 84 cStage II/III patients not given Neo, 67 (79.8%) underwent R0 esophagectomy, among whom 20 cases had pN0 (pStage II/IIa) with 3 recurrences (15%) despite infrequent Adj. On the other hand, among the 45 cStage II/III patients with Neo, 8 pStage IIa patients exhibited poor prognosis with 5 recurrences (62.5%) as well as pStage III/IV. In pStage IIb ESCC, cStage IIa showed poorer prognosis than cStage I/IIb (P = 0.0072). Among the 21 cStage IV ESCC patients, 5 long-term survivors were experienced by multimodality treatments. CONCLUSIONS: Both cStage and Neo greatly affect ESCC prognosis irrespective of identical pStage, which must be allowed for in order to determine therapeutic strategy against ESCC.
BACKGROUND/AIMS: MuItimodality treatment improves esophageal squamous cell carcinoma (ESCC) prognosis, however the most optimal treatment still remains controversial. METHODOLOGY: In 213 ESCC patients who had operation at Kitasato University Hospital between 1996 and 2007, prognosis was evaluated in terms of cStage and adjuvant therapy. RESULTS: Survival outcome of with the 62 cStage I ESCC were excellent (2 recurrences) with infrequent postoperative treatment (Adj). Of 129 ESCC patients with cStage II/III, 45 patients including suspicious cT4 (cT3.5) were given neoadjuvant therapy (Neo), and pStage 0/I patients showed excellent prognosis. Of 84 cStage II/III patients not given Neo, 67 (79.8%) underwent R0 esophagectomy, among whom 20 cases had pN0 (pStage II/IIa) with 3 recurrences (15%) despite infrequent Adj. On the other hand, among the 45 cStage II/III patients with Neo, 8 pStage IIa patients exhibited poor prognosis with 5 recurrences (62.5%) as well as pStage III/IV. In pStage IIb ESCC, cStage IIa showed poorer prognosis than cStage I/IIb (P = 0.0072). Among the 21 cStage IV ESCC patients, 5 long-term survivors were experienced by multimodality treatments. CONCLUSIONS: Both cStage and Neo greatly affect ESCC prognosis irrespective of identical pStage, which must be allowed for in order to determine therapeutic strategy against ESCC.