Analysis of prognostic factors in esophageal cancer patients with satisfactory short-term outcome after neoadjuvant chemoradiotherapy followed by minimally invasive surgery

Objective To investigate the prognostic factor in esophageal cancer patients with satisfactory short-term outcome after neoadjuvant chemoradiotherapy followed by minimally invasive surgery(MIS). Methods From June,2011 to June,2014,21 case of locally advanced esophageal carcinoma undergoing neoadjuvant chemoradiotherapy followed by MIS and meeting the inclusion criteria were selected.According to EUS,CT and other examinations,all patients were divided into clinical stage ⅡA-ⅢB before the treatment.The first phase of treatment was concurrent chemoradiotherapy(CRT),NP has been adopted as a preoperative chemotherapy program(vinorelbine 25 mg/m²,d_1,8,22,29 and cisplatin 25 mg/m²,d_1-4,_22-25).During the same period,conventional fractionated radiotherapy with a dose of 40 Gy/20F was performed.Seven weeks after CRT,all patients received the treatment of subtotal resection of esophageal with a combined use of thoracoscopy and laparoscopy through right chest,abdomen and left cervical.Twenty-one cases of patients were of satisfactory recent efficacy:pathological remission in the primary tumor,smooth implementation of surgery,without postoperative major complications.Age,gender,tumor location,tumor size,clinical stage before the treatment,neoadjuvant chemoradiotherapy completion,the time interval between neoadjuvant chemoradiotherapy and MIS,operation duration,perioperative bleeding,the cleaned lymph node region and the number,positive lymph node pathology,hospital stay and other related factors have been multivariate analyzed. Results For 21 patients of satisfactory recent efficacy,the follow-up was 16 to 60(44.6±12.6) months,the 3-year and 5-year survival rates were 85.21%,73.85%,respectively.The multivariate analysis showed the age,metastatic lymph nodes were the independent prognostic factors. Conclusion The regimen of neoadjuvant chemoradiotherapy followed by MIS in the treatment of locally advanced esophageal carcinoma is efficacy,especially for patients with satisfactory short-term outcome.But the heterogeneity of tumor,individual differences,age,lymph node metastasis and other factors may affect the prognosis.