Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma
Abstract Background In this study, we retrospectively examined the prognostic significance of the pathological status of esophageal squamous cell carcinoma (ESCC) patients following neoadjuvant chemoradiotherapy (NCRT) and surgery. Methods Data of patients with cT2-4aN0-3 stage ESCC who underwent NC...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12885-025-13465-w |
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| author | Xiaofeng Duan Jie Yue Shangren Wang Fangdong Zhao Wencheng Zhang Shuo Qie Hongjing Jiang |
| author_facet | Xiaofeng Duan Jie Yue Shangren Wang Fangdong Zhao Wencheng Zhang Shuo Qie Hongjing Jiang |
| author_sort | Xiaofeng Duan |
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| description | Abstract Background In this study, we retrospectively examined the prognostic significance of the pathological status of esophageal squamous cell carcinoma (ESCC) patients following neoadjuvant chemoradiotherapy (NCRT) and surgery. Methods Data of patients with cT2-4aN0-3 stage ESCC who underwent NCRT and esophagectomy during 2014–2022 were reviewed retrospectively. Survival differences were compared according to revised TN (rTN) stage (ypT0N0, ypT + N0, ypT0N+, and ypT + N+) using univariate and Cox regression analyses. Results Of the 136 patients (59.1 ± 7.2 y) included in this study, 123 (90.4%) were males. There were 39 (28.7%) patients with ypT0N0 disease, 49 (36.0%) ypT + N0, 11 (8.1%) ypT0N+, and 37 (27.2%) ypT + N+. Additionally, 126 patients had a median follow-up period of 30 (1–90) months. The 5-year overall survival was 81.6% in ypT0N0 group, 53.1% for ypT + N0, 50.0% for ypT0N+, and 18.6% for ypT + N+ (p < 0.001) and 5-year disease-free survival was 70.1% for ypT0N0, 39.7% for ypT + N0, 33.3% for ypT0N+, and 18.4% for ypT + N+ (p < 0.001). The ypT + N0 and ypT0N + groups showed no significant differences in survival (p > 0.05). In Cox regression analysis, ypT stage and rTN stage showed an independent association with OS (p = 0.026 and 0.001, respectively). During the follow-up period, 69 (54.8%) patients developed recurrence, with ypT0N0 patients experiencing fewer local and distant recurrences compared to other groups (p < 0.001). Conclusion In ESCC patients, the ypT0N0 status after NCRT predicts prolonged survival, but this reduces significantly when nodal metastases or residual primary lesions are present. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-01-01 |
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| series | BMC Cancer |
| spelling | doaj-art-19c03fbf586b44a28fc6dacec2dfa8dc2025-01-12T12:27:48ZengBMCBMC Cancer1471-24072025-01-0125111110.1186/s12885-025-13465-wPrognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinomaXiaofeng Duan0Jie Yue1Shangren Wang2Fangdong Zhao3Wencheng Zhang4Shuo Qie5Hongjing Jiang6Department of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerDepartment of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerDepartment of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerDepartment of Radiation Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerDepartment of Radiation Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerDepartment of Pathology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerDepartment of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for CancerAbstract Background In this study, we retrospectively examined the prognostic significance of the pathological status of esophageal squamous cell carcinoma (ESCC) patients following neoadjuvant chemoradiotherapy (NCRT) and surgery. Methods Data of patients with cT2-4aN0-3 stage ESCC who underwent NCRT and esophagectomy during 2014–2022 were reviewed retrospectively. Survival differences were compared according to revised TN (rTN) stage (ypT0N0, ypT + N0, ypT0N+, and ypT + N+) using univariate and Cox regression analyses. Results Of the 136 patients (59.1 ± 7.2 y) included in this study, 123 (90.4%) were males. There were 39 (28.7%) patients with ypT0N0 disease, 49 (36.0%) ypT + N0, 11 (8.1%) ypT0N+, and 37 (27.2%) ypT + N+. Additionally, 126 patients had a median follow-up period of 30 (1–90) months. The 5-year overall survival was 81.6% in ypT0N0 group, 53.1% for ypT + N0, 50.0% for ypT0N+, and 18.6% for ypT + N+ (p < 0.001) and 5-year disease-free survival was 70.1% for ypT0N0, 39.7% for ypT + N0, 33.3% for ypT0N+, and 18.4% for ypT + N+ (p < 0.001). The ypT + N0 and ypT0N + groups showed no significant differences in survival (p > 0.05). In Cox regression analysis, ypT stage and rTN stage showed an independent association with OS (p = 0.026 and 0.001, respectively). During the follow-up period, 69 (54.8%) patients developed recurrence, with ypT0N0 patients experiencing fewer local and distant recurrences compared to other groups (p < 0.001). Conclusion In ESCC patients, the ypT0N0 status after NCRT predicts prolonged survival, but this reduces significantly when nodal metastases or residual primary lesions are present.https://doi.org/10.1186/s12885-025-13465-wNeoadjuvant therapyChemoradiotherapyEsophageal squamous cell carcinomaEsophagectomy |
| spellingShingle | Xiaofeng Duan Jie Yue Shangren Wang Fangdong Zhao Wencheng Zhang Shuo Qie Hongjing Jiang Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma BMC Cancer Neoadjuvant therapy Chemoradiotherapy Esophageal squamous cell carcinoma Esophagectomy |
| title | Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma |
| title_full | Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma |
| title_fullStr | Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma |
| title_full_unstemmed | Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma |
| title_short | Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma |
| title_sort | prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma |
| topic | Neoadjuvant therapy Chemoradiotherapy Esophageal squamous cell carcinoma Esophagectomy |
| url | https://doi.org/10.1186/s12885-025-13465-w |
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