scholarly journals A novel preoperative plasma indicator to predict prognoses for patients with esophageal squamous cell carcinoma after radical esophagectomy: fibrinogen-to-lymphocyte ratio

2019 ◽  
Vol Volume 11 ◽  
pp. 4719-4728 ◽  
Author(s):  
Ningbo Fan ◽  
Dongni Chen ◽  
Jiabo Zheng ◽  
Zhesheng Wen ◽  
Peng Lin
2020 ◽  
Author(s):  
Ryoma Haneda ◽  
Eisuke Booka ◽  
Kenjiro Ishii ◽  
Hirotoshi Kikuchi ◽  
Yoshihiro Hiramatsu ◽  
...  

Abstract Background: The standard treatment for patients with clinical T1bN0M0 esophageal squamous cell carcinoma is radical esophagectomy. Definitive chemoradiotherapy is regarded as a treatment option, and good clinical outcome of this treatment has been reported. This study compared the efficacy of definitive chemoradiotherapy with radical esophagectomy.Methods: From January 2011 to December 2019, this study enrolled 68 consecutive patients. Patients were classified into two groups whether treated by surgery or definitive chemoradiotherapy. Survival outcome were compared and subsequent therapies after recurrence were also investigated.Results: Surgery was performed to 39 patients, and 29 patients received definitive chemoradiotherapy. No significant difference was noted in overall survival between two groups. However, the rate of 5-year recurrence free survival was significantly lower in definitive chemoradiotherapy group than that of surgery group (91.1% vs. 62.7%, Hazard ratio 3.976, 95% Confidence interval 1.076-14.696, p = 0.039). Patients who had local recurrence after definitive chemoradiotherapy received endoscopic submucosal dissection or photodynamic therapy as salvage therapies, and resulted in no disease progression and a good prognosis.Conclusions: Definitive chemoradiotherapy may become a promising alternative therapy comparable with radical esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma. Early detection of recurrence by frequent follow-up after definitive chemoradiotherapy is important to control disease within local recurrence, and salvage therapy for local lesions could contribute to long-term survival.


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 145-145
Author(s):  
Yohei Nagai ◽  
Naoya Yoshida ◽  
Yoshifumi Baba ◽  
Hideo Baba

Abstract Background To investigate the association between endoscopic response evaluation of neoadjuvant chemotherapy (NAC) with pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC). Methods We retrospectively reviewed the medical records of patients with the aid of a prospectively entered database. One hundred and eleven consecutive patients with ESCC who underwent radical esophagectomy after NAC were included. All patients were divided into two groups according to endoscopic response after NAC: endoscopic non-responders in whom NAC was poorly or moderately effective, and endoscopic responders in whom NAC was highly effective or completely effective. The clinical response after NAC was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST). Results The pretreatment clinical stage was IB in 5 patients (5%), II in 18 (16%), III in 72 (65%), and IV in 16 (14%). All patients received two courses of chemotherapy. Chemotherapy consisted of docetaxel, cisplatin (CDDP), and 5-fluorouracil (5-FU; the DCF regimen) in 82 patients (74%), and 5-FU and CDDP (FP) in 29 (26%). All patients underwent radical esophagectomy with 2- or 3-field lymph node dissection. The postoperative mortality and morbidity rates were 0.9% and 26%, respectively. Pathological stage (ypStage) was 0 in 1 patient (1%), I in 16 (14%), II in 31 (28%), III in 48 (43%), and IV in 15 (13%). Twenty-two patients (20%) were pathological responders, and this group of patients had better overall survival than pathological non-responders (P = 0.02). Pathological response was significantly correlated with tumor depth (cT) (P < 0.01), protruding type of tumor (P = 0.01) before NAC, and clinical response (P < 0.01) and endoscopic response (P < 0.01) after NAC. Of these clinical factors, clinical response and endoscopic response were significantly correlated with prognosis. Conclusion Endoscopic response after NAC can predict the pathological response and prognosis of patients who received NAC followed by surgery. Endoscopic findings are clinically significant to assess the response of NAC in patients with ESCC. Disclosure All authors have declared no conflicts of interest.


Sign in / Sign up

Export Citation Format

Share Document