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Factors associated with survival in patients with oesophageal cancer who achieve pathological complete response after chemoradiotherapy: a nationwide population-based study

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机构: [1]Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Div Thorac Surg, Taoyuan, Taiwan; [2]Natl Yang Ming Univ, Inst Hlth & Welf Policy, 155,Sec 2,Li Nong St, Taipei 112, Taiwan; [3]Changhua Christian Hosp, Dept Surg, Div Thorac Surg, Taichung, Taiwan; [4]Chung Shan Med Univ, Inst Med, Taichung, Taiwan; [5]Taipei Vet Gen Hosp, Dept Surg, Div Thorac Surg, Taipei, Taiwan; [6]Natl Yang Ming Univ, Sch Med, Taipei, Taiwan; [7]Koo Fdn Sun Yat Sen Canc Ctr, Dept Surg, Div Thorac Surg, Taipei, Taiwan
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关键词: Oesophageal cancer Pathological complete response Squamous cell carcinoma

摘要:
OBJECTIVES: Few data are currently available on the factors associated with survival in oesophageal cancer patients who achieve pathological complete response (pCR) after chemoradiotherapy (CRT). Using a nationwide database, we investigated the predictors of survival in this patient group. METHODS: Data were retrieved from the Taiwan Cancer Registry to identify patients with oesophageal squamous cell carcinoma (OSCC) who achieved pCR after CRT followed by oesophagectomy between 2008 and 2013. The median number of dissected nodes (20) was used as the cut-off to classify the extent of lymph node dissection (LND). Tumour location was defined according to the seventh edition of the American Joint Committee on Cancer staging system. Cox proportional hazard regression analyses were used to identify factors associated with survival. RESULTS: Of the 1103 patients who underwent CRT followed by surgery, 319 (28.9%) achieved pCR. Thirty-and 90-day mortality rates were 3.5 and 4.7%, respectively. The 3-year overall survival rate was 55.9%. Multivariate Cox survival analysis identified age >= 55 years [hazard ratio (HR): 1.72, 95% confidence interval (CI): 1.07 to 2.78, P = 0.025], an LND number of <20 (HR: 1.62, 95% CI: 1.01 to 2.61, P = 0.047) and lesions located in the upper third (HR: 2.35, 95% CI: 1.18 to 4.65, P = 0.015) as adverse prognostic factors for survival in pCR patients. CONCLUSIONS: Patient age >= 55 years, upper third lesions and an LND number of <20 are adverse prognostic factors in OSCC patients who achieve pCR following CRT. High-risk patients should be strictly followed.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 2 区 外科 3 区 心脏和心血管系统 3 区 呼吸系统
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 呼吸系统 2 区 外科 3 区 心脏和心血管系统
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第一作者机构: [1]Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Div Thorac Surg, Taoyuan, Taiwan;
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通讯机构: [2]Natl Yang Ming Univ, Inst Hlth & Welf Policy, 155,Sec 2,Li Nong St, Taipei 112, Taiwan;
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