Abstract
Introduction
Despite there are robust data supporting neoadjuvant radiochemotherapy in oesophageal
cancer, some doubts subsist concerning the real effect on the different histological subtypes.
In this study, we compared long-term overall survival in squamous cell carcinoma (SCC) and
adenocarcinoma (AD) depending upon neoadjuvant radiochemotherapy (NAT).
Patients & Methods
Patients were selected from our institutional database from January 2000 until December
2013. The eligibility criteria were: Adenocarcinoma or squamous cell carcinoma, stage I-IVa
and patients with and without neoadjuvant treatment.
For the primary endpoint, the overall survival was compared according to the response to
neoadjuvant treatment. Then, we subdivided the pathological response in “Down-staging”
group for a partial response and in “ypCR” group for the pathological complete response.
Then we compared the effect of down-staging on overall survival same way as mentioned.
Finally, we compared patients with NAT and a surgery against patients who only had surgery.
Results
Only primary endpoint - Without subdivision of histological sub-types 32.7% had no response
to NAT, 47.3% had a down-staging (without ypCR) and 20% a pathological complete response.
They had an overall survival of 45 [2-97], 39[14.4-63.6], 43 months [37.4-48.6] (p=0.78),
respectively. The difference of survival were statistically not significant. The overall median
survival period was 43 months [33-53 months].
Conclusion
Our retrospective study did not demonstrate any advantage in overall survival period on
groups with ypCR against those without. The subtypes analysis did not show a difference
either. Finally, we also compared our survival data with the current literature. Our results
showed that patients with advanced stage who receive a NAT retrieve similar survival as
patients with early stages, which is in line with other studies.
In conclusion, our retrospective study supports the current literature about the interest of
multimodal treatment for patients with oesophageal cancer. They are needed to determine
the most accurate chemo or radio treatment for each histological subtype and if they should
be treated with different regimens.