THE IMPACT OF NEOADJUVANT ONCOLOGICAL TREATMENT AND SURGICAL OESOPHAGECTOMY FOR OESOPHAGEAL CANCER ON OVERALL SURVIVAL A SINGLE CENTER SERIES

Résumé 0

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.