Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes?
ObjectivesNeoadjuvant immunochemotherapy (nICT) is a novel pattern for locally advanced esophageal squamous cell carcinoma (ESCC), and the time to surgery (TTS) is recommended as 4-6 weeks. However, there were some patients with prolonged TTS(> 6 weeks). This study aimed to explore whether pr...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1036396/full |
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| author | Zhi-Nuan Hong Zhi-Nuan Hong Zhi-Nuan Hong Zhi-Nuan Hong Zhixin Huang Zhixin Huang Zhixin Huang Zhixin Huang Kai Weng Kai Weng Kai Weng Kai Weng Jihong Lin Jihong Lin Jihong Lin Jihong Lin Mingqiang Kang Mingqiang Kang Mingqiang Kang Mingqiang Kang |
| author_facet | Zhi-Nuan Hong Zhi-Nuan Hong Zhi-Nuan Hong Zhi-Nuan Hong Zhixin Huang Zhixin Huang Zhixin Huang Zhixin Huang Kai Weng Kai Weng Kai Weng Kai Weng Jihong Lin Jihong Lin Jihong Lin Jihong Lin Mingqiang Kang Mingqiang Kang Mingqiang Kang Mingqiang Kang |
| author_sort | Zhi-Nuan Hong |
| collection | DOAJ |
| description | ObjectivesNeoadjuvant immunochemotherapy (nICT) is a novel pattern for locally advanced esophageal squamous cell carcinoma (ESCC), and the time to surgery (TTS) is recommended as 4-6 weeks. However, there were some patients with prolonged TTS(> 6 weeks). This study aimed to explore whether prolonged TTS (> 6 weeks) would affect the outcomes.MethodsPatients diagnosed with locally advanced ESCC between January 2020 and March 2022 and undergoing esophagectomy following nICT were identified based on a prospectively collected database. Primary outcome measures were pathological complete response (pCR) and disease-free survival (DFS), and the secondary outcomes were 30-day postoperative mortality and morbidity, surgical time, postoperative hospital stay, and hospital expense.ResultsTotal of 95 patients were included for analysis, with 52 patients in the standard TTS group and 43 patients in the prolonged TTS group. The clinical and demographic characteristics of the two groups were comparable. The prolonged group had a median 18 days longer TTS(P<0.001). The pCR rate was 23.08% (12/52) in the standard group and 16.28% (7/43) in the prolonged group (P=0.41). Multivariate regression analysis further indicated that TTS wasn’t an independent factor in predicting pCR (P=0.41). The median follow-up time was 10.5 months in the standard TTS group and 11.2 months in the prolonged TTS group. A total of five recurrences occurred with two events in the standard TTS group and three events in the prolonged TTS group, and no significant difference was observed in DFS(P=0.60). Both groups were comparable in postoperative hospital stays, total hospital stay, hospital expenses, and comprehensive complications index (CCI). The complications and major complications were also similar in both groups. Spearman test further indicated that there was no linear correlation among TTS with hospital expenses, postoperative hospital stays, hospital stay, CCI index, lymph nodes moved number, or surgical time, with a p-value of 0.48, 0.63, 0.80, 0.92, 0.09, 0.38 respectively.ConclusionsBased on present evidence, TTS after completion of nICT is not of major importance concerning pathological response, disease-free survival, and short-term postoperative outcomes. |
| first_indexed | 2024-04-13T18:25:07Z |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-13T18:25:07Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Immunology |
| spelling | doaj.art-a7fa08dc01754d9fa5df3c036a1620932022-12-22T02:35:16ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10363961036396Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes?Zhi-Nuan Hong0Zhi-Nuan Hong1Zhi-Nuan Hong2Zhi-Nuan Hong3Zhixin Huang4Zhixin Huang5Zhixin Huang6Zhixin Huang7Kai Weng8Kai Weng9Kai Weng10Kai Weng11Jihong Lin12Jihong Lin13Jihong Lin14Jihong Lin15Mingqiang Kang16Mingqiang Kang17Mingqiang Kang18Mingqiang Kang19Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaKey Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, ChinaKey Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, ChinaFujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, ChinaDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaKey Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, ChinaKey Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, ChinaFujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, ChinaDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaKey Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, ChinaKey Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, ChinaFujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, ChinaDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaKey Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, ChinaKey Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, ChinaFujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, ChinaDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaKey Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, ChinaKey Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, ChinaFujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, ChinaObjectivesNeoadjuvant immunochemotherapy (nICT) is a novel pattern for locally advanced esophageal squamous cell carcinoma (ESCC), and the time to surgery (TTS) is recommended as 4-6 weeks. However, there were some patients with prolonged TTS(> 6 weeks). This study aimed to explore whether prolonged TTS (> 6 weeks) would affect the outcomes.MethodsPatients diagnosed with locally advanced ESCC between January 2020 and March 2022 and undergoing esophagectomy following nICT were identified based on a prospectively collected database. Primary outcome measures were pathological complete response (pCR) and disease-free survival (DFS), and the secondary outcomes were 30-day postoperative mortality and morbidity, surgical time, postoperative hospital stay, and hospital expense.ResultsTotal of 95 patients were included for analysis, with 52 patients in the standard TTS group and 43 patients in the prolonged TTS group. The clinical and demographic characteristics of the two groups were comparable. The prolonged group had a median 18 days longer TTS(P<0.001). The pCR rate was 23.08% (12/52) in the standard group and 16.28% (7/43) in the prolonged group (P=0.41). Multivariate regression analysis further indicated that TTS wasn’t an independent factor in predicting pCR (P=0.41). The median follow-up time was 10.5 months in the standard TTS group and 11.2 months in the prolonged TTS group. A total of five recurrences occurred with two events in the standard TTS group and three events in the prolonged TTS group, and no significant difference was observed in DFS(P=0.60). Both groups were comparable in postoperative hospital stays, total hospital stay, hospital expenses, and comprehensive complications index (CCI). The complications and major complications were also similar in both groups. Spearman test further indicated that there was no linear correlation among TTS with hospital expenses, postoperative hospital stays, hospital stay, CCI index, lymph nodes moved number, or surgical time, with a p-value of 0.48, 0.63, 0.80, 0.92, 0.09, 0.38 respectively.ConclusionsBased on present evidence, TTS after completion of nICT is not of major importance concerning pathological response, disease-free survival, and short-term postoperative outcomes.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1036396/fullneoadjuvant immunochemotherapyesophageal squamous cell carcinomatime to surgeryminimally invasive esophagectomydisease free survival |
| spellingShingle | Zhi-Nuan Hong Zhi-Nuan Hong Zhi-Nuan Hong Zhi-Nuan Hong Zhixin Huang Zhixin Huang Zhixin Huang Zhixin Huang Kai Weng Kai Weng Kai Weng Kai Weng Jihong Lin Jihong Lin Jihong Lin Jihong Lin Mingqiang Kang Mingqiang Kang Mingqiang Kang Mingqiang Kang Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes? Frontiers in Immunology neoadjuvant immunochemotherapy esophageal squamous cell carcinoma time to surgery minimally invasive esophagectomy disease free survival |
| title | Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes? |
| title_full | Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes? |
| title_fullStr | Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes? |
| title_full_unstemmed | Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes? |
| title_short | Does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes? |
| title_sort | does time to esophagectomy following neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma affect outcomes |
| topic | neoadjuvant immunochemotherapy esophageal squamous cell carcinoma time to surgery minimally invasive esophagectomy disease free survival |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1036396/full |
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