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



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.


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.


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


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.


All authors have declared no conflicts of interest.