ArticleEsophagus : official journal of the Japan Esophageal Society2025
Initial reduction of the primary tumor or lymph nodes: which is the better prognostic factor in patients with esophageal squamous cell carcinoma receiving neoadjuvant chemotherapy followed by surgery?
Article in Esophagus : official journal of the Japan Esophageal Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Pathological responses to neoadjuvant immunochemotherapy: implications for survival and recurrence in patients with locally advanced esophageal squamous cell carcinoma.Journal of translational medicine · 2025Article
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12 authors.
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Abstract
backgroundEarly response of the primary tumor (PT) to neoadjuvant chemotherapy (NAC) in patients with esophageal squamous cell carcinoma (ESCC) is considered a potential predictor of postoperative prognosis. However, the role of metastatic lymph nodes (LNs) remains poorly understood. This study aimed to compare the predictive value of early response in PT and LNs for postoperative prognosis.
methodsWe enrolled 124 consecutive patients who received NAC-docetaxel, cisplatin, 5-fluorouracil (DCF) followed by surgery for ESCC between April 2010 and March 2020. Initial tumor reduction of the PT (ITR-PT) and LN (ITR-LN), defined as the percentage decrease in tumor shorter diameter after the first course of NAC-DCF, was evaluated using computed tomography. The optimal cut-off values of ITRs were determined using receiver operating characteristic curves and Cox regression models, and their relationship with recurrence-free survival (RFS) was analyzed.
resultsThe median ITR-PT and ITR-LN were 21.77% and -0.88%, respectively. The optimal cut-off values for predicting prognosis were approximately 10% for ITR-PT (hazard ratio [HR], 3.23; 95% confidence interval [CI], 1.84-5.64) and -10% for ITR-LN (HR, 2.20; 95% CI, 1.27-3.80). ITR-PT showed a greater impact on RFS (3-year RFS: ITR-PT ≥ 10%, 66.1%; ITR-PT < 10%, 18.4%; log-rank P < 0.001) compared with ITR-LN (3-year RFS: ITR-LN ≥ -10%, 64.1%; ITR-PT < -10%, 34.3%; log-rank P = 0.004). Multivariate analysis of RFS identified ypN, ITR-PT, and ITR-LN as independent prognostic factors.
conclusionsBoth ITR-PT and ITR-LN are promising predictors of survival in patients with ESCC who underwent NAC-DCF plus surgery. ITR-PT may be a stronger prognostic factor than ITR-LN.
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