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Prognostic factors in patients receiving neoadjuvant 5‐fluorouracil plus cisplatin for advanced esophageal cancer (JCOG9907)
Abstract
OBJECTIVE: Neoadjuvant chemotherapy with 5-fluorouracil plus cisplatin and subsequent esophagectomy with two- to three-field lymphadenectomy is a standard treatment for patients with clinical stage II/III squamous cell carcinoma (SCC) of the esophagus. This study investigates the prognostic factors for patients who received neoadjuvant chemotherapy. METHODS: Of 164 patients assigned to receive neoadjuvant chemotherapy in the JCOG9907 trial, multivariate analyses were performed for 159 and 149 patients to evaluate the preoperative and the combined preoperative and postoperative prognostic factors, respectively. RESULTS: The multivariate analyses using preoperative factors showed that clinical stage T3 [vs. cT1-2; hazard ratio (HR) 3.60, p = 0.0007] and serum albumin (Alb) <4.0 g/dl (vs. ≥ 4.0 g/dl; HR 2.29, p = 0.0005) were associated with a poor prognosis. Four independent prognostic factors were identified by multivariate analysis of both preoperative and postoperative factors: pathological curability B (pB; R0 with stage IV or pD < pN) or pC [microscopic or macroscopic residual tumor (R1/R2)] [vs. pA (R0); HR 1.93, p = 0.015], pathological stage N1 (vs. pN0; HR 3.86, p = 0.0012), cT3 (vs. cT1-2; HR 2.80, p = 0.0073), and serum Alb <4.0 g/dl (vs. ≥ 4.0 g/dl; HR 2.03, p = 0.0069). CONCLUSIONS: Preoperative cT stage, Alb, and postoperative pathological findings are independent prognostic factors for patients undergoing neoadjuvant chemotherapy for advanced thoracic esophageal SCC. This analysis may aid in stratification according to individual patient risk.
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Hypoalbuminemia often proves to be a strong independent risk factor for failure of chemotherapy and for mortality.
“Hypoalbuminemia often proves to be a strong independent risk factor for failure of chemotherapy and for mortality.138, 140, 141, 142, 143, 144, 145, 146”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [140]
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Metadata
- Authors
- Yokota, T., Ando, N., Igaki, H., Shinoda, M., Kato, K., Mizusawa, J., Katayama, H., Nakamura, K., Fukuda, H., & Kitagawa, Y.
- Affiliations
- Shizuoka Cancer Center (JP)
- International Goodwill Hospital (JP)
- Aichi Cancer Center (JP)
- National Cancer Center Hospital (KR)
- National Cancer Centre Japan (JP)
- Keio University (JP)
- ORCID
- Venue
- Oncology
- Publisher
- S. Karger AG
- Published
- 2015
- Volume
- 89
- Issue
- 3
- Pages
- 143-151
- ISSN
- 0030-2414 (ISSN-L)
- 1423-0232
- OpenAlex
- W2053054248
- Cited by
- 36
- References
- 24
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 2 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 6 · 2016: 4 · 2015: 1
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- esophageal squamous cell carcinoma, neoadjuvant chemotherapy, 5-fluorouracil, cisplatin, prognostic factors, esophagectomy, lymph node dissection, serum albumin, pathological stage, clinical T stage, residual tumor
- MeSH terms
- Esophageal Squamous Cell Carcinoma, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Squamous Cell, Cisplatin, Esophageal Neoplasms, Female, Fluorouracil, Humans, Japan, Male, Middle Aged, Neoplasm Staging, Prognosis, Risk Factors, Serum Albumin, Esophagectomy, Treatment Outcome, Chemotherapy, Adjuvant, Neoplasm, Residual, Neoadjuvant Therapy
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