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. 2021 Jan;51(1):118-126.
doi: 10.1007/s00595-020-02059-7. Epub 2020 Jun 28.

Controlling lymph node micrometastases by neoadjuvant chemotherapy affects the prognosis in advanced esophageal squamous cell carcinoma

Yoko Hiraki  1 , Yutaka Kimura  2 , Motohiro Imano  1 , Hiroaki Kato  1 , Mitsuru Iwama  1 , Osamu Shiraishi  1 , Atsushi Yasuda  1 , Masayuki Shinkai  1 , Tomoki Makino  3 , Masaaki Motoori  4 , Makoto Yamasaki  3 , Hiroshi Miyata  5 , Takao Satou  6 , Taroh Satoh  7 , Hiroshi Furukawa  1 , Masahiko Yano  5 , Yuichiro Doki  3 , Takushi Yasuda  1
Affiliations

Controlling lymph node micrometastases by neoadjuvant chemotherapy affects the prognosis in advanced esophageal squamous cell carcinoma

Yoko Hiraki et al. Surg Today. 2021 Jan.

Abstract

Purpose: The purpose of this study is to determine the clinical significance of micrometastases after neoadjuvant chemotherapy (NAC) and the difference in controlling micrometastases using different NAC regimens in resectable advanced esophageal squamous cell carcinoma (ESCC).

Methods: We analyzed patients with ESCC who underwent esophagectomy with lymph node dissection after NAC with Adriamycin + cisplatin + 5-fluorouracil (ACF) or docetaxel + cisplatin + 5-fluorouracil (DCF). Micrometastasis was defined as a single isolated cancer cell or cluster of cancer cells on the cervical, recurrent nerve, or abdominal LNs as shown by immunohistochemical staining with anti-cytokeratin antibody (AE1/AE3). The associations between micrometastases, recurrence, prognosis, and regimen differences were investigated.

Results: One hundred and one cases (ACF group: 51 cases; DCF group: 50 cases) were analyzed. Micrometastases occurred in 24 patients (23.8%): 17/51 (33.3%) in the ACF group and 7/50 (13.5%) in the DCF group (p = 0.0403). The 5-year recurrence-free survival (RFS) rates for patients without (n = 77) and with (n = 24) micrometastases were 62 and 32%, respectively, (hazard ratio, 2.158; 95% confidence interval, 1.170-3.980; stratified log-rank test, p = 0.0115). A multivariate analysis showed that stage pN1 or higher and micrometastases were significant risk factors affecting RFS.

Conclusion: In resectable advanced ESCC, controlling micrometastases in the LNs after NAC varied by regimen and may be associated with preventing ESCC recurrence.

Keywords: Esophageal squamous cell carcinoma; Micrometastases; Neoadjuvant chemotherapy.

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References

    1. Kelsen DP, Ginsberg R, Pajak TF, Sheahan DG, Gunderson L, Mortimer J, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med. 1998;339:1979–84. - PubMed
    1. van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–84. - PubMed
    1. Sjoquist KM, Burmeister BH, Smithers BM, Zalcberg JR, Simes RJ, Barbour A, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol. 2011;12:681–92. - PubMed
    1. Mayanagi S, Irino T, Kawakubo H, Kitagawa Y. Neoadjuvant treatment strategy for locally advanced thoracic esophageal cancer. Ann Gastroenterol Surg. 2019;3:269–75. - PubMed - PMC
    1. Kitagawa Y, Uno T, Oyama T, Kato K, Kato H, Kawakubo H, et al. Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus. 2019;16:1–24. - PubMed

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