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首页> 外文期刊>International Journal of Radiation Oncology, Biology, Physics >Initial stage affects survival even after complete pathologic remission is achieved in locally advanced esophageal cancer: analysis of 70 patients with pathologic major response after preoperative chemoradiotherapy.
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Initial stage affects survival even after complete pathologic remission is achieved in locally advanced esophageal cancer: analysis of 70 patients with pathologic major response after preoperative chemoradiotherapy.

机译：即使在局部晚期食管癌中达到完全病理缓解后，初始阶段也会影响生存：分析70例术前放化疗后病理主要反应的患者。

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摘要

PURPOSE: To analyze outcomes and factors predictive for recurrence and survival in patients with operable esophageal carcinoma who achieved pathologic complete response (PCR) or microscopic residual disease (MRD) after preoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: Outcomes were assessed in 70 patients with locally advanced esophageal cancer who achieved pathologic major response (53 with PCR and 17 with MRD) after preoperative CRT. RESULTS: At a median follow-up of 38.6 months for surviving patients, 17 of 70 patients (24.3%) experienced disease recurrence and 31 (44.3%) died. Clinical stage (II vs III; p = 0.013) and pathologic response (PCR vs. MRD; p = 0.014) were independent predictors of disease recurrence. Median overall survival (OS) was 99.6 months (95% CI, 44.1-155.1 months) and the 5-year OS rate was 57%. Median recurrence-free survival (RFS) was 71.5 months (95% CI, 39.5-103.6 months) and the 5-year RFS rate was 51.3%. Median OS of patients with Stage II and Stage III disease was 108.8 months and 39.9 months, respectively, and the 5-year OS rates were 68.2% and 27.0%, respectively (p = 0.0003). In a subgroup of patients with PCR, median OS and RFS were also significantly different according to clinical stage. Multivariate analysis showed that clinical stage was an independent predictor of RFS (p = 0.01) and OS (p = 0.008). CONCLUSIONS: Even though patients achieved major response after preoperative CRT, pretreatment clinical stage is an important prognostic marker for recurrence and survival. Patients with MRD have an increased recurrence risk but similar survival compared with patients achieved PCR.
机译：目的：分析可手术食管癌患者在术前放化疗后达到病理完全缓解（PCR）或镜下残留病灶（MRD）的结果和可预测复发和生存的因素。材料与方法：对70例局部晚期食管癌患者在术前CRT后达到病理学主要反应（PCR为53，MRD为17）进行了评估。结果：存活患者的中位随访时间为38.6个月，其中70例患者中有17例（24.3％）经历了疾病复发，有31例（44.3％）死亡。临床分期（II vs III; p = 0.013）和病理反应（PCR vs. MRD; p = 0.014）是疾病复发的独立预测因子。中位总生存期（OS）为99.6个月（95％CI，44.1-155.1个月），5年OS率为57％。中位无复发生存期（RFS）为71.5个月（95％CI，39.5-103.6个月），五年期RFS率为51.3％。 II期和III期患者的中位OS分别为108.8个月和39.9个月，而5年OS率分别为68.2％和27.0％（p = 0.0003）。在具有PCR的患者亚组中，根据临床阶段，中位OS​​和RFS也存在显着差异。多变量分析表明，临床分期是RFS（p = 0.01）和OS（p = 0.008）的独立预测因子。结论：即使患者在术前CRT后获得了重大缓解，但治疗前的临床分期仍是复发和存活的重要预后指标。与获得PCR的患者相比，MRD患者的复发风险增加，但存活率相似。

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