Risk factors and prognosis of postoperative early relapse after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma: a retrospective study
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View abstract on PubMed
Summary
This summary is machine-generated.R1 resection is a key risk factor for early relapse in locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients after neoadjuvant therapy. Early relapse significantly reduces overall survival (OS), highlighting the need for optimized postoperative management.
Area Of Science
- Oncology
- Surgical Oncology
- Gastroenterology
Background
- Locally advanced esophageal squamous cell carcinoma (LA-ESCC) requires multimodal treatment, including neoadjuvant therapy and surgery.
- Early postoperative relapse poses a significant challenge, impacting patient survival outcomes.
- Optimizing postoperative management strategies is crucial for improving survival in LA-ESCC patients.
Purpose Of The Study
- To identify risk factors for early postoperative relapse in LA-ESCC patients treated with neoadjuvant therapy.
- To evaluate the impact of these risk factors on survival outcomes, including overall survival (OS) and survival after relapse (SAR).
- To inform clinical strategies for better postoperative management of LA-ESCC.
Main Methods
- Retrospective analysis of 183 LA-ESCC patients who underwent neoadjuvant therapy and surgical resection.
- Patients were categorized into early relapse (≤6 months) and late relapse (>6 months) groups.
- Logistic regression, multivariate regression, Cox regression, and Kaplan-Meier analyses were used to identify risk factors and assess survival.
Main Results
- R1 resection, advanced postoperative TNM stage (III-IV), ypN+ stage, lymphovascular invasion (LVI), perineural invasion (PI), and lack of adjuvant therapy were risk factors for early relapse.
- R1 resection was identified as an independent predictor of early relapse.
- Early relapse was associated with significantly reduced OS (12.5 vs. 26.9 months) and SAR (5.9 vs. 11.0 months).
- LVI was a prognostic factor for OS in patients with early relapse.
Conclusions
- R1 resection is an independent risk factor for rapid postoperative relapse in LA-ESCC patients post-neoadjuvant therapy.
- Lymphovascular invasion (LVI) significantly impacts patient survival outcomes.
- Early relapse is strongly linked to reduced overall survival (OS), emphasizing the need for vigilant follow-up and management.
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