AccScience Publishing / ARNM / Volume 2 / Issue 3 / DOI: 10.36922/arnm.3821
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ORIGINAL RESEARCH ARTICLE

Neoadjuvant chemoradiotherapy for T3N0M0 esophageal squamous cell carcinoma

Ying Liu1† ,  Yehan Zhou2† ,  Xiaoding Zhou1 ,  Jingqiu Li1 ,  Jie Zhu1 ,  Yi Wang1 ,  Lei Wu1 ,  Gang Wan1 ,  Xuefeng Leng3 ,  Guangyuan Liu3 ,  Yongtao Han3 ,  Yang Liu2 ,  Lin Peng3 ,  Qifeng Wang1*
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1 Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, China
2 Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, China
3 Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, China
ARNM 2024, 2(3), 3821 https://doi.org/10.36922/arnm.3821
Submitted: 2 June 2024 | Accepted: 8 July 2024 | Published: 11 September 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The optimal treatment for patients with pretreatment T3N0M0 (pre-T3N0M0) esophageal squamous cell carcinoma (ESCC) remains controversial. This study evaluated the impact of neoadjuvant chemoradiotherapy (NCRT) on the survival outcomes of individuals diagnosed with pre-T3N0M0 ESCC. A total of 443 patients with pre-T3N0M0 ESCC who underwent either NCRT plus surgery (NCRT + S) or surgery alone were included in the study. In the surgery group, patients with post-operative staging of pathological T3N0M0 (pT3N0M0) were classified as pre-T3N0M0. In the NCRT + S group, due to tumor downstaging after NCRT, patients with pre-treatment clinical T3 and post-operative pathology indicating lymph nodes without evidence of tumor involvement or regression were considered to have pre-T3N0M0. Univariate and multivariate Cox analyses were conducted to identify independent prognostic factors influencing overall survival (OS) in pre-T3N0M0 patients. Kaplan–Meier curves were employed to assess disparities in OS and disease-free survival (DFS) between the two groups. Compared to surgery alone, NCRT + S significantly enhanced the OS (Hazard ratio [HR] = 0.572, 95% Confidence interval [CI] = 0.407 – 0.804; P = 0.0059); however, it did not show a significant benefit in DFS (HR = 0.784, 95% CI = 0.564 – 1.09; P = 0.17). Compared with the surgery group, patients who achieved a pathologically complete response (pCR) after NCRT showed significantly improved OS (HR = 0.522, 95% CI = 0.339 – 0.804; P = 0.019). The overall and locoregional recurrence rates were significantly lower in the NCRT + S group than in the surgery group. Compared with surgery alone, NCRT + S significantly improved OS in patients with pre-T3N0M0 stage disease, especially in those who achieved pCR after NCRT.

Keywords
Esophageal cancer
Neoadjuvant chemoradiotherapy
Surgery
T3N0M0
Prognosis
Funding
This work was supported by the Science and Technology Department of Sichuan Province (2023YFS0488 and 2023YFQ0055), Sichuan.
Conflict of interest
The authors declare no conflicts of interest.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing
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