236P - Comparing chemo-radiotherapy with 5-fluorouracil and cisplatin versus thoracoscopic esophagectomy for cStage II-III esophageal squamous cell carcinoma

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Tomomi Kashiwada
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors T. Kashiwada1, Y. Harada1, Y. Yoda2, H. Noshiro2, N. Aragane1, S. Kimura1
  • 1Division Of Hematology, Respiratory Medicine And Oncology, Saga Univ Facilty of Medicine-Nabeshima, 849-0937 - Saga/JP
  • 2Surgery, Saga Univ Facilty of Medicine-Nabeshima, 849-0937 - Saga/JP

Abstract

Background

Definitive chemoradiotherapy is one of the curative options for resectable esophageal squamous cell carcinoma with organ preservation. In this single-center observational study, we evaluated the efficacy of chemoradiotherapy (CRT) with cisplatin (CDDP) and 5-fluorouracil (5-FU) and thoracoscopic esohagectomy with or without preoperative chemotherapy for cStage II-III esophageal squamous cell carcinoma.

Methods

Between April 2009 and December 2012, 85 cStage II-III esophageal squamous cell carcinoma were enrolled in this study. CRT group were CDDP 70 mg/m2 was administered on days 1 and 29, and 5-FU 700 mg/m2/day was administered on days 1–4 and 29–32. Fractionated radiotherapy was performed on days 1–21 and 29–49; a total dose of 60 Gy was delivered at the rate of 2 Gy per fraction. Surgical resection group were performed thoracoscopic esophagectomy with lymphadenectomy (>D2) with or without preoperative chemotherapy.Final analysis was conducted in June 2016. Survival was monitored for 3 years.

Results

Overall survival (OS) of cStageIII patients with CRT was shorter than that of patients with thoracoscopic esophagectomy [hazard ratio, HR 0.431, 95% confidence interval, CI, (0.20-0.95)] and disease-free survival (DFS) also tended to be shorter in patients with chemo-radiotherapy [HR 0.606, (0.28-1.32)]. The OS of cStageII patients with CRT was nearly identical to that for patients with thoracoscopic esophagectomy [HR 0.621, (0.24-1.62)] and DFS showed the same tendency [HR 0.578, (0.25-1.34].

Conclusions

Surgical resection was confirmed to offer a superior survival benefit to the StageIII esophageal cancer, but there are several limitations to our study. This study was retrospective and determination factors of patients' decision between surgery and CRT were may be affected from the therapeutic effect of preoperative chemotherapy, their performance status and surgical complication rate of the facility. Therefore, selection bias cannot be excluded.The optimal balance of risks versus benefits for the thoracoscopic esophagectomy with chemotherapy should probably be assessed more cautiously in the future.

Clinical trial indentification

Legal entity responsible for the study

Saga University

Funding

Saga University

Disclosure

All authors have declared no conflicts of interest.