639P - The influence of chemotherapy-induced leucopenia (CIL) during preoperative chemotherapy (pre-Cx) on survival in esophageal squamous cell carcinoma...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Complications of Treatment
Presenter Hiroki Hara
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors H. Hara1, N. Ando2, H. Igaki3, M. Shinoda4, K. Kato5, Y. Kitagawa6, J. Mizusawa7, K. Nakamura7
  • 1Department Of Gastroenterology, Saitama Cancer Center Hospital, 362-0806 - Saitama/JP
  • 2Surgical Oncology, International Goodwill Hospital, Yokohama/JP
  • 3Esophageal Surgery Division, National Cancer Center Hospital, Tokyo/JP
  • 4Surgical Oncology, Aichi Cancer Center, Nagoya/JP
  • 5Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 6Department Of Surgery, Keio University School of Medicine, JP-160-8582 - Tokyo/JP
  • 7Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, 104-0045 - Tokyo/JP

Abstract

Aim

CIL has been reported to be predictive of better survival in some studies with various malignant tumors especially in metastatic setting. However, the relationship between CIL and survival in pre-Cx for the patients (pts) with ESCC has not been well discussed. We analyzed the association of CIL with overall survival (OS) using the data of JCOG9907 in which pre-Cx showed survival advantage over postoperative chemotherapy in stage II/III ESCC.

Methods

Pre-Cx consisted of two courses of 5-FU (800mg/m2 day1-5) and cisplatin (80mg/m2 day1) repeated every 3 weeks. Among the pts assigned to pre-Cx arm in JCOG9907, we analyzed the pts who underwent surgery and also whose leucocytes were measured as scheduled. They were divided into two groups: group A, those who experienced Gr. 2-4 leucopenia at least once during pre-Cx; group B, those with Gr.0-1. The association of CIL with OS, progression-free survival (PFS) was analyzed with multivariate analyses using Cox proportional hazard model.

Results

A total of 152 out of 164 pts who assigned to pre-Cx arm were included in this analysis, where 52 pts were classified into group A and 100 pts to group B. There were no remarkable differences between group A and B in their background except for age and sex. 3-year OS for group A were inferior to group B (48.1% vs 73.9%; hazard ratio (HR) = 1.94, p = 0.0074). As for 3-year PFS, similar tendency was observed (44.2% vs 55.8%; HR = 1.38, p = 0.16). There was no difference of frequency of postoperative infectious complications between the two groups. As is shown in the table, multivariate analysis identified CIL had inferior tendency to survival (HR = 1.54, p = 0.10).

Multivariate analysis of OS
Factors category HR 95% CI p-value
Leucocyte Gr. 2-4 (vs. 0-1) 1.54 0.93-2.55 0.10
CT T3 (vs. T1-2) 2.70 1.26-5.78 0.010
Albumin >4.0 g/dL (vs. <4.0) 0.44 0.26-0.73 0.0016
Dose of chemotherapy Actual /planned dose >90% (vs. <90%) 0.52 0.29-0.94 0.030
Pathological response Gr. 2-3 (vs. 0-1) 0.37 0.15-0.94 0.037

Conclusions

CIL was reported to be a positive prognostic factor, but was shown to be a negative prognostic factor in this study. The meaning of CIL should be discussed further.

Disclosure

All authors have declared no conflicts of interest.