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Erschienen in: Esophagus 3/2023

20.01.2023 | Original Article

Old age and intense chemotherapy exacerbate negative prognostic impact of postoperative complication on survival in patients with esophageal cancer who received neoadjuvant therapy: a nationwide study from 85 Japanese esophageal centers

verfasst von: Satoru Matsuda, Yuko Kitagawa, Jun Okui, Akihiko Okamura, Hirofumi Kawakubo, Ryo Takemura, Manabu Muto, Yoshihiro Kakeji, Hiroya Takeuchi, Masayuki Watanabe, Yuichiro Doki

Erschienen in: Esophagus | Ausgabe 3/2023

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Abstract

Background

The prognostic impact of docetaxel, cisplatin, and 5-FU (DCF) reported in JCOG1109 was successfully validated using real-world data in patients < 75 years old. However, DCF was not reported to be beneficial in elderly patients with a relatively higher postoperative complication incidence. This study aimed to clarify the impact of postoperative complications on the prognosis of ESCC and the difference in the magnitude of the impact by age and regimen.

Methods

Patients with esophageal squamous cell carcinoma (ESCC) who underwent subtotal esophagectomy at 85 authorized institutes were retrospectively reviewed from 2010 to 2015. The prognostic impact of postoperative anastomotic leakage (AL) and pneumonia on survival was evaluated. The prognostic value of the postoperative complications was assessed by stratifying patients according to age and neoadjuvant chemotherapy regimen.

Results

Patients with AL, pneumonia, and infectious complications (ICs: a combination of pneumonia and AL) showed significantly worse overall survival (OS). IC served as a negative prognostic factor of OS and recurrence-free survival, and its negative prognostic impact was more evident in patients aged > 75 years. When the patients were further stratified by chemotherapeutic regimens, using the CF/IC(−) group as a reference, the DCF/IC (+) group showed significantly shorter OS in patients aged > 75 years with a hazard ratio (HR) of 2.551. The HR of the CF/IC (+) group was 1.503.

Conclusions

The negative impact of postoperative complications on survival was confirmed in this nationwide study. Furthermore, its magnitude was higher in elderly patients who received triplet chemotherapy.
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Metadaten
Titel
Old age and intense chemotherapy exacerbate negative prognostic impact of postoperative complication on survival in patients with esophageal cancer who received neoadjuvant therapy: a nationwide study from 85 Japanese esophageal centers
verfasst von
Satoru Matsuda
Yuko Kitagawa
Jun Okui
Akihiko Okamura
Hirofumi Kawakubo
Ryo Takemura
Manabu Muto
Yoshihiro Kakeji
Hiroya Takeuchi
Masayuki Watanabe
Yuichiro Doki
Publikationsdatum
20.01.2023
Verlag
Springer Nature Singapore
Erschienen in
Esophagus / Ausgabe 3/2023
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-022-00980-z

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