631P - Prognostic stratification of pathologic stage in patients with preoperative chemoradiotherapy followed by curative esophagectomy for localized esop...

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Oesophageal Cancer
Gastrointestinal Cancers
Pathology/Molecular Biology
Surgery and/or Radiotherapy of Cancer
Presenter Jihoon Kang
Citation Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369
Authors J. Kang1, S.R. Park1, Y. Kim2, H.R. Kim2, J.H. Kim3, H. Jung4, G. Lee4, H.J. Song4, D.H. Kim4, K.D. Choi4, J. Ryu5, K. Cho6, S. Kim1
  • 1Oncology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 2Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 3Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 4Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 5Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 6Pathology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR

Abstract

Background

While the majority of advanced-stage esophageal cancers are treated with surgery after neoadjuvant chemoradiotherapy (NCRT), the utility of prognostication of pathologic TNM stage (pTNM) after NCRT (ypTNM) remains elucidated. Since ypTNM stage could be influenced by pretreatment tumor burden or treatment efficacy of NCRT, ypTNM stage-specific groups might be heterogeneous in terms of prognosis. Identifying prognostic factors in ypTNM stage-specific groups would guide more detailed prognostication.

Methods

From 2007 to 2014, 569 patients with squamous cell carcinoma who underwent R0 surgery with NCRT (n = 222) or who underwent R0 surgery alone (n = 347) were included. We performed uni- and multivariate analysis to identify prognostic factors for overall survival (OS) in patients with surgery after NCRT based on pTNM stages (AJCC 7th).

Results

The 5-year OS rates for patients with ypTNM stage 0, 1 (including pT0N+M0), 2 and 3 in surgery after NCRT group were 74.1%, 51.6%, 29.4%, and 17.5% (P 

Conclusions

In patients with surgery after NCRT, pathologic prognostic factors (LVI and PNI) were significantly associated with the prognosis of advanced stages, whereas clinical prognostic factors (cCR, clinical stages and age) were of early stages. Although further studies are needed to validate the results of this study, we carefully suggest that clinical and pathological factors have a role in predicting survival outcome in detail based on ypTNM stage by stratifying each ypTNM stage into groups showing distinct survival profiles.

Clinical trial identification

Legal entity responsible for the study

Asan Medical Center, Department of Oncology

Funding

None

Disclosure

All authors have declared no conflicts of interest.