Keishi Yamashita1, Natsuya Katada2, Hiromitsu Moriya2, Kei Hosoda2, Hiroaki Mieno2, Chikatoshi Katada3, Wasaburo Koizumi3, Keika Hoshi4, Masahiko Watanabe2. 1. Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. keishi23@med.kitasato-u.ac.jp. 2. Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. 3. Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan. 4. Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Japan.
Abstract
BACKGROUND: Neoadjuvant chemotherapy (NAC) with CF (cisplatin/5-FU) was demonstrated to improve survival of clinical stage II/III (cStage II/III) esophageal squamous cell carcinoma (ESCC), however prognostic outcome remains unsatisfactory. We have recently reported preliminary potentiality of short-term survival benefit by NAC with DCF (docetaxel/cisplatin/5-FU). PATIENTS AND METHODS: Thirty-eight ESCC patients who underwent DCF NAC between 2009 and 2012 were investigated for prognosis with a median follow-up period of 49 months as compared to those with CF NAC. RESULTS: (1) ESCC patients with DCF NAC showed 66% of 3-year progression-free survival (PFS), which is significantly superior to that of CF NAC (38%) (p = 0.018). ESCC patients with DCF NAC showed 79% of 3-year overall survival (OS), which is marginally significantly superior to that of CF NAC (65%) (p = 0.093). (2) The multivariate Cox proportional hazards model revealed that DCF NAC was an independent prognostic factor for PFS (p = 0.0013) and OS (p = 0.047), respectively, when adjusted for patient sex, age, cT, cN, and preoperative borderline resectability. (3) Patients with more advanced stage were rather frequently included in DCF NAC than in CF NAC, however there was no significant difference. Nevertheless, propensity score (PS) to predict DCF NAC was significantly higher than CF NAC (p = 0.019). (4) Both NAC and PS were again applied to the multivariate Cox proportional hazards model, and DCF NAC was the only remnant prognostic indicator for PFS (p = 0.0044) and OS (p = 0.063). CONCLUSION: Prognosis may be significantly improved in cStage II/III ESCC patients who underwent DCF NAC than those with CF NAC.
BACKGROUND: Neoadjuvant chemotherapy (NAC) with CF (cisplatin/5-FU) was demonstrated to improve survival of clinical stage II/III (cStage II/III) esophageal squamous cell carcinoma (ESCC), however prognostic outcome remains unsatisfactory. We have recently reported preliminary potentiality of short-term survival benefit by NAC with DCF (docetaxel/cisplatin/5-FU). PATIENTS AND METHODS: Thirty-eight ESCC patients who underwent DCF NAC between 2009 and 2012 were investigated for prognosis with a median follow-up period of 49 months as compared to those with CF NAC. RESULTS: (1) ESCC patients with DCF NAC showed 66% of 3-year progression-free survival (PFS), which is significantly superior to that of CF NAC (38%) (p = 0.018). ESCC patients with DCF NAC showed 79% of 3-year overall survival (OS), which is marginally significantly superior to that of CF NAC (65%) (p = 0.093). (2) The multivariate Cox proportional hazards model revealed that DCF NAC was an independent prognostic factor for PFS (p = 0.0013) and OS (p = 0.047), respectively, when adjusted for patient sex, age, cT, cN, and preoperative borderline resectability. (3) Patients with more advanced stage were rather frequently included in DCF NAC than in CF NAC, however there was no significant difference. Nevertheless, propensity score (PS) to predict DCF NAC was significantly higher than CF NAC (p = 0.019). (4) Both NAC and PS were again applied to the multivariate Cox proportional hazards model, and DCF NAC was the only remnant prognostic indicator for PFS (p = 0.0044) and OS (p = 0.063). CONCLUSION: Prognosis may be significantly improved in cStage II/III ESCC patients who underwent DCF NAC than those with CF NAC.
Authors: Jan B F Hulscher; Johanna W van Sandick; Angela G E M de Boer; Bas P L Wijnhoven; Jan G P Tijssen; Paul Fockens; Peep F M Stalmeier; Fiebo J W ten Kate; Herman van Dekken; Huug Obertop; Hugo W Tilanus; J Jan B van Lanschot Journal: N Engl J Med Date: 2002-11-21 Impact factor: 91.245
Authors: Tao Wang; Jie Yu; Min Liu; Yanliang Chen; Caiyun Zhu; Lin Lu; Mingzhu Wang; Lingfeng Min; Xinxin Liu; Xizhi Zhang; Johannes A Gubat; Yong Chen Journal: Drug Des Devel Ther Date: 2019-02-05 Impact factor: 4.162