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
1058 - Assessment of CPS+EG, Neo-Bioscore and modified Neo-Bioscore in breast cancer patients treated with preoperative systemic therapy: a multicenter cohort study
Presenter: LING XU
Session: Poster Display session 2
Resources:
Abstract
1156 - The concordance of treatment decision guided by Oncotype and the PREDICT tool in early stage breast cancer
Presenter: Hadar Goldvaser
Session: Poster Display session 2
Resources:
Abstract
3447 - Influence of first treatment delay on survival among breast cancer subtypes
Presenter: Irene Zarcos Pedrinaci
Session: Poster Display session 2
Resources:
Abstract
3505 - Clinical features of early-stage (I-III) triple-negative breast cancer (TNBC) patients with tumors exhibiting low-overall change in molecular profile after neoadjuvant therapy.
Presenter: Nour Abuhadra
Session: Poster Display session 2
Resources:
Abstract
5442 - Meta-analysis in HER2+ early breast cancer therapies and cost-effectiveness in a Brazilian perspective
Presenter: Marcos Magalhaes
Session: Poster Display session 2
Resources:
Abstract
1570 - Anti-mullerian hormone (AMH) levels and antral follicle counts (AFC) may predict ovarian reserves before systemic chemotherapy (SC) in women with breast cancer(BC); a prospective clinical study
Presenter: Cetin Ordu
Session: Poster Display session 2
Resources:
Abstract
2698 - Prognosis of selected triple negative apocrine breast cancer patients who did not receive adjuvant chemotherapy.
Presenter: Giuseppe Cancello
Session: Poster Display session 2
Resources:
Abstract
3104 - Novel Blood Based Circulating Tumor Cell Biomarker For Breast Cancer Detection
Presenter: Chun-Yu Liu
Session: Poster Display session 2
Resources:
Abstract
4631 - Multi-Gene Prognostic Signatures and Prediction of Pathological Complete Response of ER-Positive HER2-Negative Breast Cancer Patients to Neo-Adjuvant Chemotherapy
Presenter: Claudia Mazo
Session: Poster Display session 2
Resources:
Abstract
4632 - Impact of menopause status on breast cancer outcomes and amenorrhea incidence during adjuvant tailored dose dense chemotherapy
Presenter: Andri Papakonstantinou
Session: Poster Display session 2
Resources:
Abstract