Clinical Analysis Of The Interval Between Neoadjuvant Chemoradiotherapy And Surgery For Esophageal Cancer

【Objective】Neoadjuvant chemoradiotherapy(NCRT)combined with surgery is an important mode of treatment for locally advanced esophageal cancer.However,the optimal interval between neoadjuvant chemoradiotherapy and surgery is still unclear.This study retrospectively analyzed the clinicopathological data of patients who received neoadjuvant chemoradiotherapy combined with radical resection of esophageal cancer in 9OO hospital of joint logistics support force,to explore the influence of the difference in the interval between neoadjuvant chemoradiotherapy and surgery on the intraoperative situation and postoperative efficacy of esophageal cancer.【Methods】Retrospective analysis of clinical data of 106 patients who successfully completed esophageal cancer resection after neoadjuvant radiotherapy in cardiothoracic surgery department of 9OO hospitals of the joint logistic support force from January 2012 to June 2014.Patients were divided into long interval groups(>7weeks,n=43)and short interval groups(≤7 weeks,n=63)according to the interval between neoadjuvant chemoradiation and surgery.The general clinical data,operation time,intraoperative blood loss,margin of resection,lymph node dissection,ICU time,hospitalization time,postoperative complication rate,mortality,pathological complete remission rate,and postoperative survival time were compared between the two groups,through the Cox multiple factors analysis of factors affecting the prognosis of patients with locally advanced esophageal cancer survival.【Results】There was no significant difference in gender,age,tumor location,tumor differentiation degree,clinical stage and preoperative complications between the two groups(P>0.05).There were no significant differences in the operation time,intraoperative blood loss,mean lymph node dissection,number of converted chests,postoperative intensive care unit time and postoperative hospital stay between the two groups(P>0.05).The total postoperative complication rate was 48.8%(21/43)in the long interval group,and the hospital mortality rate was 4.7%(2/43).The total complication rate was 42.9%in the short interval group(27/63),the hospital mortality rate was 1.6%(1/63).There was no significant difference in the incidence of complications between the two groups and the hospital mortality(χ~2=0.369,P=0.544).There was no significant difference in the pathological stage and margin of the tumor between the two groups.The pathologic complete response rate(pCR)was 32.6%(14/43)in the long interval group and 27.0%(17/63)in the short interval group.The long interval group improved the postoperative pCR trend.However,the difference was not statistically significant(P>0.05).There was no significant difference in the overall survival between the two groups(P>0.05).Univariate analysis showed that pCR and pTNM staging were prognostic factors affecting the survival of locally advanced esophageal squamous cell carcinoma.Multivariate regression model analysis showed pTNM staging was an independent prognostic factor for locally advanced esophageal squamous cell carcinoma.【Conclusion】1.The interval between different neoadjuvant chemoradiation and surgery had no statistically significant effect on the operation time,intraoperative blood loss,perioperative complication rate,mortality and hospitalization time of esophageal cancer patients.2.esophageal cancer neoadjuvant radiotherapy and chemotherapy and surgery interval>7weeks,pathologic complete respons was better,but no significant difference was found between the two groups.3.pCR and pTNM staging were prognostic factors affecting the survival of locally advanced esophageal squamous cell carcinoma.pTNM staging was an independent prognostic factor for locally advanced esophageal squamous cell carcinoma.