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  • [Anticancer Res.] A Randomized Phase III Trial on the Role of Esophagectomy in Complete Responders to Preoperative Chemoradiotherapy for Esophageal Squamous Cell Carcinoma (ESOPRESSO).

    울산의대 / 박숙련, 윤덕현, 김성배*

  • 출처
    Anticancer Res.
  • 등재일
    2019 Sep
  • 저널이슈번호
    39(9):5123-5133. doi: 10.21873/anticanres.13707.
  • 내용

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    Abstract
    BACKGROUND/AIM:
    We investigated the role of esophagectomy after clinical complete response (cCR) to chemoradiotherapy for esophageal squamous cell carcinoma (ESCC).

    PATIENTS AND METHODS:
    Patients with resectable cT3-T4a/anyN/M0 or anyT/N+/M0 thoracic ESCC received two cycles of induction chemotherapy and then chemoradiotherapy (50.4 Gy/28 fractions). Patients with cCR were randomized to surgery or observation.

    RESULTS:
    Among 86 patients, 38 (44.2%) achieved cCR after chemoradiotherapy; 37 were randomized to surgery (n=19) or observation (n=18). Although there were trends of better disease-free survival (DFS) toward the surgery arm in the intent-to-treat analysis (2-year DFS, 66.7% vs. 42.7%; p=0.262) or as-treated analysis (66.7% vs. 50.2%; p=0.273), overall survival was not different between the two arms in the intent-to-treat (HR=1.48; p=0.560) or as-treated analysis (HR=1.09; p=0.903). Among the 11 patients having recurrence during observation, 8 underwent surgery (n=7) or endoscopic dissection (n=1).

    CONCLUSION:
    Close observation with salvage surgery might be a reasonable option in resectable ESCC patients achieving cCR after chemoradiation.

     


    Author information

    Park SR1, Yoon DH1, Kim JH2, Kim YH3, Kim HR3, Lee HJ4, Jung HY5, Lee GH5, Song HJ5, Kim DH5, Choi KD5, Lee JH5, Ahn JY5, Ryu JS6, Cho KJ7, Kim SB8.
    1
    Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    2
    Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    3
    Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    4
    Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    5
    Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    6
    Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    7
    Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    8
    Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea sbkim3@amc.seoul.kr.

  • 키워드
    Esophageal squamous cell carcinoma; chemoradiotherapy; clinical complete response; induction chemotherapy; observation; surgery
  • 편집위원

    CCRT 후 clinical CR을 획득한 환자에서 추가치료를 결정할 때 근거논문으로 생각됩니다.

    2019-10-30 15:45:07

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