Prognostic Impact of Postoperative Lymph Node Metastases After Neoadjuvant Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of Esophagus: From the Results of NEOCRTEC5010, a Randomized Multicenter Study.
机构：[1]Sichuan Cancer Hospital & Research Institute, School of Medicine, University of Electronic Science and Technology of China (UESTC), Chengdu, China四川省人民医院四川省肿瘤医院[2]Sun Yat-sen University Cancer Center, Guangzhou, China[3]Cancer Hospital of Shantou University Medical College, Shantou, China[4]Taizhou Hospital, Wenzhou Medical University, Taizhou, China台州恩泽医疗中心(集团)台州医院[5]Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China[6]Tianjin Medical University Cancer Hospital, Tianjin, China[7]Zhejiang Cancer Hospital, Hangzhou, China浙江省肿瘤医院[8]Fudan University Shanghai Cancer Center, Shanghai, China[9]The University of Hong Kong-Shenzhen Hospital, Hong Kong, China.深圳医学信息中心香港大学深圳医院
To determine the prognostic impact of pathologic lymph node (LN) status and investigate risk factors of recurrence in esophageal squamous cell carcinoma (ESCC) patients with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT).There are no large-scale prospective study data regarding ypN status and recurrence after pCR in ESCC patients receiving NCRT.The NEOCRTEC5010 trial was a prospective multicenter trial that compared the survival and safety of NCRT plus surgery (S) with S in patients with locally advanced ESCC. The relationships between survival and cN, pN, and ypN status were assessed. Potential prognostic factors in patients with ypN+ and pCR were identified.A total of 389 ESCC patients (NCRT: 182; S: 207) were included. Patients with pN+ in the S group and ypN+ in the NCRT group had decreased overall survival (OS) and disease-free survival (DFS) compared with pN0 and ypN0 patients, respectively. Partial response at the primary site [hazard ratio (HR), 2.09] and stable disease in the LNs (HR, 3.26) were independent risk factors for lower DFS, but not OS. For patients with pCR, the recurrence rate was 13.9%. Patients with distant LN metastasis had a median OS and DFS of 16.1 months and 14.4 months, respectively. Failure to achieve the median total dose of chemotherapy was a significant risk factor of recurrence and metastasis after pCR (HR, 44.27).Persistent pathologic LN metastasis after NCRT is a strong poor prognostic factor in ESCC. Additionally, pCR does not guarantee a cure; patients with pCR should undergo an active strategy of surveillance and adjuvant therapy.
基金：
Supported by Grant No. 2018SZ0199 from the Program of Science and Technology of Sichuan Province; Grant No. 179 from the Health Ministry of China; Grant No. 2007048 from the Sun Yat-sen University Clinical Research5010 Program; Grant No. 81272635 from the National Science Foundation of China; Grant No. 2012A030400007 from the Science and Technology Fund for Projects of Guangdong Province; and Grant No.2011C13039-2 from the Major Science and Technology Special Fund for Projects of Zhejiang Province.
第一作者机构：[1]Sichuan Cancer Hospital & Research Institute, School of Medicine, University of Electronic Science and Technology of China (UESTC), Chengdu, China
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推荐引用方式(GB/T 7714)：
Xuefeng Leng,Wenwu He,Hong Yang,et al.Prognostic Impact of Postoperative Lymph Node Metastases After Neoadjuvant Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of Esophagus: From the Results of NEOCRTEC5010, a Randomized Multicenter Study.[J].ANNALS OF SURGERY.2021,274(6):E1022-E1029.doi:10.1097/SLA.0000000000003727.
APA：
Xuefeng Leng,Wenwu He,Hong Yang,Yuping Chen,Chengchu Zhu...&Yongtao Han.(2021).Prognostic Impact of Postoperative Lymph Node Metastases After Neoadjuvant Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of Esophagus: From the Results of NEOCRTEC5010, a Randomized Multicenter Study..ANNALS OF SURGERY,274,(6)
MLA：
Xuefeng Leng,et al."Prognostic Impact of Postoperative Lymph Node Metastases After Neoadjuvant Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of Esophagus: From the Results of NEOCRTEC5010, a Randomized Multicenter Study.".ANNALS OF SURGERY 274..6(2021):E1022-E1029
医学