- Neoadjuvant chemoradiation (NACR) is linked to a higher rate of pathologic complete response (pCR), but worse short- and long-term survival, in resectable esophageal cancer.
Why this matters
- NACR has a survival benefit in squamous cell carcinoma, but it is unclear whether it benefits patients with esophageal cancer more broadly, especially those with adenocarcinoma.
- Retrospective analysis of the National Cancer Database (n=12,238).
- Funding: None disclosed.
- 92.1% underwent NACR.
- There was no significant difference in OS between the neoadjuvant chemotherapy and NACR groups (37.6 vs 35.9 months; P=.393).
- NACR was associated with a greater frequency of pCR (19.2% vs 6.3%; HR, 2.593; P<.001>
- pCR response was associated with better 3-year survival (38.4% vs 31.6%; P<.001 but there was no difference in survival among patients with a pcr who had undergone chemotherapy vs nacr not reached months p=".745).</li">
- Among patients who did not achieve pCR, chemotherapy was associated with better OS (37.3 vs 30.8 months; P=.002), and chemoradiotherapy was associated with higher 90-day mortality (HR, 1.872; P=.036).
- Cox regression analysis showed that NACR was a predictor of worse OS (HR, 1.561; P<.001>
- Retrospective analysis.