초록접수 현황
| 14F-245 | 구연 발표 |
Concurrent Chemoradiotherapy Followed by Esophagectomy for Advanced Esophageal Squamous Cell Carcinoma
윤주식, 강승구, 김순진, 김도완, 송상윤, 김상형, 나국주
전남대학교 의과대학 흉부외과학교실
Background : Although advanced esophageal carcinoma has a poor prognosis, recent reports have shown better outcomes with multimodality therapy. The aim of this study was to evaluate the prognosis of patients with advanced esophageal carcinoma undergoing esophagectomy following neoadjuvant concurrent chemoradiotherapy (CCRT) compared to definitive CCRT.
Methods : This study is a retrospective review of 109 patients undergoing esophagectomy following neoadjuvant CCRT (n=36) or definitive CCRT (n=73) for advanced squamous cell carcinoma (T3-4 and/or N1) during 2005 to 2012. Clinical characteristics, surgical outcomes and survival of esophagectomy following neoadjuvant CCRT were compared with that of definitive CCRT.
Results : In esophagectomy following neoadjuvant CCRT group, postoperative morbidity rate was 50%, and in-hospital mortality rate was 11.1%. There were no significant differences between two groups with respect to mean age (63.6 ± 8.5 vs 66.3 ± 8.3 years, p=0.113) and male-female ratio (35:1 vs 71:2, p=0.991). In survival analysis, there were no significant differences in overall survival (p=0.681) and recurrence-free survival (p=0.515) between two groups. However, we could find a trend toward better survival rates in esophagectomy following neoadjuvant CCRT group (Overall 3-, 5-year survival rates: 46.6%, 40.7% vs 33.2%, 23.8% and recurrence-free 3-, 5-year survival rates: 56.3%, 56.3% vs 48.7%, 38.6%).
Conclusion : Compared to definitive CCRT, Esophagectomy following neoadjuvant CCRT showed a trend toward better prognosis for advanced esophageal squamous cell carcinoma without statistical significance. However, we need to consider the relatively high morbidity and mortality associated with esophagectomy after neoadjuvant CCRT.
Methods : This study is a retrospective review of 109 patients undergoing esophagectomy following neoadjuvant CCRT (n=36) or definitive CCRT (n=73) for advanced squamous cell carcinoma (T3-4 and/or N1) during 2005 to 2012. Clinical characteristics, surgical outcomes and survival of esophagectomy following neoadjuvant CCRT were compared with that of definitive CCRT.
Results : In esophagectomy following neoadjuvant CCRT group, postoperative morbidity rate was 50%, and in-hospital mortality rate was 11.1%. There were no significant differences between two groups with respect to mean age (63.6 ± 8.5 vs 66.3 ± 8.3 years, p=0.113) and male-female ratio (35:1 vs 71:2, p=0.991). In survival analysis, there were no significant differences in overall survival (p=0.681) and recurrence-free survival (p=0.515) between two groups. However, we could find a trend toward better survival rates in esophagectomy following neoadjuvant CCRT group (Overall 3-, 5-year survival rates: 46.6%, 40.7% vs 33.2%, 23.8% and recurrence-free 3-, 5-year survival rates: 56.3%, 56.3% vs 48.7%, 38.6%).
Conclusion : Compared to definitive CCRT, Esophagectomy following neoadjuvant CCRT showed a trend toward better prognosis for advanced esophageal squamous cell carcinoma without statistical significance. However, we need to consider the relatively high morbidity and mortality associated with esophagectomy after neoadjuvant CCRT.
책임저자: 나국주
전남대학교 의과대학 흉부외과학교실
연락처 : 윤주식, Tel: 061-379-7770 , E-mail : jusikyun@gmail.com
