Post-op Chemo Has Limited Benefit in Some Esophageal Cancers

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The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Patients with stage IIA and IIB esophageal squamous cell carcinoma (ESCC) with lymphovascular invasion (LVI) but negative lymph nodes do not benefit from postoperative chemotherapy.

Why This Matters

  • Whether adjuvant chemotherapy benefits patients with ESCC and LVI but negative lymph nodes is unclear.

  • The current study helps clarify the uncertainty. Findings indicate no significant survival advantage for patients with stage IIA and IIB disease.

Study Design

  • Researchers compared outcomes of 22 patients who had received postoperative chemotherapy after radical resection of ESCC at Henan Cancer Hospital in China with 24 patients who had not.

  • Most chemotherapy patients received intravenous paclitaxel plus platinum therapy (such as cisplatin, nedaplatin, or carboplatin) once every 3 weeks for four cycles.

  • Patients were treated from 2015–2016.

Key Results

  • The 5-year overall survival was 40.9% in the chemotherapy group, vs 41.7% in the no-chemotherapy group.

  • On subgroup analysis, the authors found no significant difference in 5-year overall survival between the chemotherapy and the no-chemotherapy group for patients with stage IIA and IIB disease. In addition, there was no statistical difference in recurrence-free survival between the groups.

  • The 5-year overall survival rate among stage IB patients was about two times higher in the chemotherapy arm (83.3% vs 40.0%), though this difference was also not significant (P = .151).

  • Local lymph node and bone metastases were the main recurrence patterns.

Limitations

  • It was a retrospective study with a small number of patients, and the findings were confounded by selection bias.

  • The proportion of patients who underwent thoracoscopic surgery was significantly higher in the chemotherapy group.

  • For some patients, causes of death could not be accurately assessed.

Disclosures

  • There was no funding for the work, and the investigators have disclosed no relevant financial relationships.

This is a summary of a preprint research study, “Effect of Postoperative Adjuvant Chemotherapy on Esophageal Squamous Cell Carcinoma Patients With Lymphovascular Invasion and Without Lymph Node Metastasis,” led by Haomiao Li of Zhengzhou University, China, provided to you by Medscape. The study has not been peer reviewed. The full text can be found at researchsquare.com.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].

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