Abstract:
BACKGROUND:This study was designed to investigate whether postoperative infectious complications (ICs) are a risk factor for the prognosis in esophageal cancer patients who receive neoadjuvant chemotherapy by stratifying the response to neoadjuvant chemotherapy. METHODS:The present study retrospectively examined patients who received neoadjuvant chemotherapy followed by esophagectomy between January 2011 and September 2015. Risk factors for overall survival (OS) were examined by Cox proportional hazard analyses. Pathological responders to neoadjuvant chemotherapy were defined as those with a tumor disappearance of more than one-third of the initial tumor. Postoperative ICs were defined using the Clavien-Dindo classification. RESULTS:Of the 111 patients examined, 45 (40.5%) developed postoperative ICs. A pathological response to neoadjuvant chemotherapy was observed in 54 (48.6%) patients. The multivariate analysis demonstrated that postoperative ICs were a significant independent risk factor for the OS (hazard ratio [HR] 2.359; 95% confidence interval [CI] 1.057-5.263, p = 0.036). In the subset analysis, postoperative ICs were a marginally significant independent risk factor for OS in the nonresponders (HR 2.862; 95% CI 0.942-8.696, p = 0.063) but not in the responders (HR 0.867; 95% CI 0.122-6.153, p = 0.886). CONCLUSIONS:These results suggested that the negative survival impact of postoperative ICs can be canceled out in esophageal cancer patients who respond to neoadjuvant chemotherapy.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Kano K,Aoyama T,Yoshikawa T,Maezawa Y,Nakajima T,Hayashi T,Yamada T,Sato T,Oshima T,Rino Y,Masuda M,Cho H,Ogata Tdoi
10.1245/s10434-018-6504-8subject
Has Abstractpub_date
2018-07-01 00:00:00pages
2034-2043issue
7eissn
1068-9265issn
1534-4681pii
10.1245/s10434-018-6504-8journal_volume
25pub_type
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