Abstract 2144
Background
Some authors have suggested that the immunological response to postoperative infectious complications (ICs) enhances the viability of undetectable residual tumor cells after surgery, thereby inducing disease recurrence. We hypothesize that recurrence might not occur if neoadjuvant chemotherapy (NAC) treatment of micrometastases can prevent residual cancer cell growth. We evaluated whether or not NAC exerted prophylactic effects against the negative prognostic impact induced by postoperative ICs and assessed its interaction among subgroups of histological response.
Methods
We retrospectively examined 111 patients who received NAC followed by radical esophagectomy between January 2011 and September 2015. Risk factors for the recurrence-free survival (RFS) were examined by Cox proportional hazard analyses. Pathological responders to NAC were defined as those with a tumor disappearance of more than one-third of the initial tumor. Postoperative ICs were defined using the Clavien–Dindo classification.
Results
A pathological response to NAC was observed in 54 (48.6 %) patients. Forty-five patients (40.5%) developed postoperative ICs. The 3-year RFS were 68.8% in the patients who developed ICs and 38.6% in the patients who did not developed ICs (p = 0.001). The multivariate analysis demonstrated that postoperative ICs were a significant independent risk factor for the RFS (hazard ratio [HR], 2.368; 95% confidence interval [CI], 1.256-4.465, p = 0.008). In the subset analysis, in responders, the 3-year RFS were 63.2% in the patients who developed ICs and 71.5% in the patients who did not developed ICs (p = 0.524). In non-responders, the 3-year RFS were 29.3% in the patients who developed ICs and 65.4% in the patients who did not developed ICs (p = 0.006). The multivariate analysis demonstrated that postoperative ICs were a significant independent risk factor for RFS in the non-responders (HR, 2.632; 95% CI, 1.072-6.467, p = 0.035) but not in the responders (HR, 1.480; 95% CI, 0.469-4.667, p = 0.503).
Conclusions
These results suggested that response to NAC can eliminate the poor prognosis induced by postoperative ICs in esophageal cancer patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3902 - The efficacy of preoperative breast cancer chemotherapy without anti-HER2-targeted treatment – single center experience in setting of no reimbursement in Poland (2011-2015)
Presenter: Agnieszka Badora-Rybicka
Session: Poster Display session 2
Resources:
Abstract
4733 - A Multicentre, International Neoadjuvant (NA), Randomized, Double-blind Phase III Trial comparing FULVESTRANT to a combination of FULVESTRANT and PALBOCICLIB in patients with operable Luminal Breast Cancer (SAFIA Trial)
Presenter: Jean-Marc Nabholtz
Session: Poster Display session 2
Resources:
Abstract
5227 - Outcome of Non-metastatic Male Breast Cancer: 222 patients
Presenter: Ulku Yalcintas Arslan
Session: Poster Display session 2
Resources:
Abstract
5943 - Effects of delayed initiation of adjuvant trastuzumab for non-metastatic, Her2 positive breast cancer in a limited resources setting: ML25232 study final results
Presenter: Samir Beslija
Session: Poster Display session 2
Resources:
Abstract
1725 - Final results of scalp cooling for hair preservation: A single- institution prospective study.
Presenter: Dario Loparco
Session: Poster Display session 2
Resources:
Abstract
3713 - Adjuvant Systemic Therapy in Women with Early Breast Cancer and Intermediate Prosigna ROR Scores: Is Chemotherapy Use Declining? Evidence From a Large Practice
Presenter: Lowell Hart
Session: Poster Display session 2
Resources:
Abstract
818 - Management of early breast cancer in women over 90: A 10 year experience
Presenter: Emily Coffey
Session: Poster Display session 2
Resources:
Abstract
1141 - Evolution in the risk of adverse events of adjuvant endocrine therapy in postmenopausal women with early- stage breast cancer.
Presenter: Daniel Reinhorn
Session: Poster Display session 2
Resources:
Abstract
2277 - Hepatitis B screening and incidence of flare among non-metastatic breast cancer patients treated with anthracyclines
Presenter: Zewen Zhang
Session: Poster Display session 2
Resources:
Abstract
2781 - Effect of denosumab on low bone mineral density in postmenopausal Japanese early breast cancer patients receiving aromatase nhibitors : 36-month results
Presenter: Koichi Sakaguchi
Session: Poster Display session 2
Resources:
Abstract