A 3-Year Overall Survival Update From a Phase 2 Study of Chemoselection With DCF and Subsequent Conversion Surgery for Locally Advanced Unresectable Esophageal Cancer

Tomoya Yokota, Ken Kato, Yasuo Hamamoto, Yasuhiro Tsubosa, Hirofumi Ogawa, Yoshinori Ito, Hiroki Hara, Takashi Ura, Takashi Kojima, Keisho Chin, Shuichi Hironaka, Takayuki Kii, Yasushi Kojima, Yasunori Akutsu, Hisayuki Matsushita, Kentaro Kawakami, Keita Mori, Takashi Makiuchi, Rie Nagumo, Yuko Kitagawa

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Abstract

Background: A multicenter phase 2 trial analysed chemoselection with docetaxel plus 5-fluorouracil and cisplatin (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for locally advanced unresectable esophageal cancer. This study presents updated 3-year analyses to further characterize the impact of DCF-ICT followed by CS. Methods: Esophageal cancer patients with clinical T4 disease, unresectable supraclavicular lymph node metastasis, or both were eligible for this study. The treatment starts with DCF-ICT, followed by CS if the cancer is resectable, or by concurrent chemoradiation if it is not resectable. This updated analysis presents 3-year overall survival (OS), 3-year progression-free survival (PFS), and pattern of relapse. Results: The median follow-up period for the patients surviving without death was 39.3 months. The estimated 1-year OS was 66.7%, and the lower limit of the 80% confidence interval (CI) was 54.6%. The estimated 3-year OS was 46.6% (95% CI 34.2–63.5%). The OS for the patients who underwent R0 resection (n = 19) was significantly longer than for those who did not (3-year OS: 71.4% vs. 30.1%). The estimated 1-year PFS was 50.6%, and the 3-year PFS was 39.6%. The PFS for R0 was significantly longer than for non-R0 (3-year PFS: 61.3% vs 25.0%). Recurrence or progression at the primary site was observed in 31% of the non-R0 group. The rate of distant metastasis did not differ significantly between the non-R0 and R0 groups (21% vs 16%). Conclusions: Long-term follow-up evaluation confirmed that DCF chemoselection aimed at CS is feasible and promising in terms of survival for patients with locally advanced esophageal cancer.

Original languageEnglish
Pages (from-to)460-467
Number of pages8
JournalAnnals of Surgical Oncology
Volume27
Issue number2
DOIs
Publication statusPublished - 2020 Feb 1

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Esophageal Neoplasms
Disease-Free Survival
Induction Chemotherapy
Survival
docetaxel
Confidence Intervals
Neoplasm Metastasis
Recurrence
Fluorouracil
Cisplatin
Lymph Nodes
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Oncology

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A 3-Year Overall Survival Update From a Phase 2 Study of Chemoselection With DCF and Subsequent Conversion Surgery for Locally Advanced Unresectable Esophageal Cancer. / Yokota, Tomoya; Kato, Ken; Hamamoto, Yasuo; Tsubosa, Yasuhiro; Ogawa, Hirofumi; Ito, Yoshinori; Hara, Hiroki; Ura, Takashi; Kojima, Takashi; Chin, Keisho; Hironaka, Shuichi; Kii, Takayuki; Kojima, Yasushi; Akutsu, Yasunori; Matsushita, Hisayuki; Kawakami, Kentaro; Mori, Keita; Makiuchi, Takashi; Nagumo, Rie; Kitagawa, Yuko.

In: Annals of Surgical Oncology, Vol. 27, No. 2, 01.02.2020, p. 460-467.

Research output: Contribution to journalArticle

Yokota, T, Kato, K, Hamamoto, Y, Tsubosa, Y, Ogawa, H, Ito, Y, Hara, H, Ura, T, Kojima, T, Chin, K, Hironaka, S, Kii, T, Kojima, Y, Akutsu, Y, Matsushita, H, Kawakami, K, Mori, K, Makiuchi, T, Nagumo, R & Kitagawa, Y 2020, 'A 3-Year Overall Survival Update From a Phase 2 Study of Chemoselection With DCF and Subsequent Conversion Surgery for Locally Advanced Unresectable Esophageal Cancer', Annals of Surgical Oncology, vol. 27, no. 2, pp. 460-467. https://doi.org/10.1245/s10434-019-07654-8
Yokota, Tomoya ; Kato, Ken ; Hamamoto, Yasuo ; Tsubosa, Yasuhiro ; Ogawa, Hirofumi ; Ito, Yoshinori ; Hara, Hiroki ; Ura, Takashi ; Kojima, Takashi ; Chin, Keisho ; Hironaka, Shuichi ; Kii, Takayuki ; Kojima, Yasushi ; Akutsu, Yasunori ; Matsushita, Hisayuki ; Kawakami, Kentaro ; Mori, Keita ; Makiuchi, Takashi ; Nagumo, Rie ; Kitagawa, Yuko. / A 3-Year Overall Survival Update From a Phase 2 Study of Chemoselection With DCF and Subsequent Conversion Surgery for Locally Advanced Unresectable Esophageal Cancer. In: Annals of Surgical Oncology. 2020 ; Vol. 27, No. 2. pp. 460-467.
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abstract = "Background: A multicenter phase 2 trial analysed chemoselection with docetaxel plus 5-fluorouracil and cisplatin (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for locally advanced unresectable esophageal cancer. This study presents updated 3-year analyses to further characterize the impact of DCF-ICT followed by CS. Methods: Esophageal cancer patients with clinical T4 disease, unresectable supraclavicular lymph node metastasis, or both were eligible for this study. The treatment starts with DCF-ICT, followed by CS if the cancer is resectable, or by concurrent chemoradiation if it is not resectable. This updated analysis presents 3-year overall survival (OS), 3-year progression-free survival (PFS), and pattern of relapse. Results: The median follow-up period for the patients surviving without death was 39.3 months. The estimated 1-year OS was 66.7{\%}, and the lower limit of the 80{\%} confidence interval (CI) was 54.6{\%}. The estimated 3-year OS was 46.6{\%} (95{\%} CI 34.2–63.5{\%}). The OS for the patients who underwent R0 resection (n = 19) was significantly longer than for those who did not (3-year OS: 71.4{\%} vs. 30.1{\%}). The estimated 1-year PFS was 50.6{\%}, and the 3-year PFS was 39.6{\%}. The PFS for R0 was significantly longer than for non-R0 (3-year PFS: 61.3{\%} vs 25.0{\%}). Recurrence or progression at the primary site was observed in 31{\%} of the non-R0 group. The rate of distant metastasis did not differ significantly between the non-R0 and R0 groups (21{\%} vs 16{\%}). Conclusions: Long-term follow-up evaluation confirmed that DCF chemoselection aimed at CS is feasible and promising in terms of survival for patients with locally advanced esophageal cancer.",
author = "Tomoya Yokota and Ken Kato and Yasuo Hamamoto and Yasuhiro Tsubosa and Hirofumi Ogawa and Yoshinori Ito and Hiroki Hara and Takashi Ura and Takashi Kojima and Keisho Chin and Shuichi Hironaka and Takayuki Kii and Yasushi Kojima and Yasunori Akutsu and Hisayuki Matsushita and Kentaro Kawakami and Keita Mori and Takashi Makiuchi and Rie Nagumo and Yuko Kitagawa",
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T1 - A 3-Year Overall Survival Update From a Phase 2 Study of Chemoselection With DCF and Subsequent Conversion Surgery for Locally Advanced Unresectable Esophageal Cancer

AU - Yokota, Tomoya

AU - Kato, Ken

AU - Hamamoto, Yasuo

AU - Tsubosa, Yasuhiro

AU - Ogawa, Hirofumi

AU - Ito, Yoshinori

AU - Hara, Hiroki

AU - Ura, Takashi

AU - Kojima, Takashi

AU - Chin, Keisho

AU - Hironaka, Shuichi

AU - Kii, Takayuki

AU - Kojima, Yasushi

AU - Akutsu, Yasunori

AU - Matsushita, Hisayuki

AU - Kawakami, Kentaro

AU - Mori, Keita

AU - Makiuchi, Takashi

AU - Nagumo, Rie

AU - Kitagawa, Yuko

PY - 2020/2/1

Y1 - 2020/2/1

N2 - Background: A multicenter phase 2 trial analysed chemoselection with docetaxel plus 5-fluorouracil and cisplatin (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for locally advanced unresectable esophageal cancer. This study presents updated 3-year analyses to further characterize the impact of DCF-ICT followed by CS. Methods: Esophageal cancer patients with clinical T4 disease, unresectable supraclavicular lymph node metastasis, or both were eligible for this study. The treatment starts with DCF-ICT, followed by CS if the cancer is resectable, or by concurrent chemoradiation if it is not resectable. This updated analysis presents 3-year overall survival (OS), 3-year progression-free survival (PFS), and pattern of relapse. Results: The median follow-up period for the patients surviving without death was 39.3 months. The estimated 1-year OS was 66.7%, and the lower limit of the 80% confidence interval (CI) was 54.6%. The estimated 3-year OS was 46.6% (95% CI 34.2–63.5%). The OS for the patients who underwent R0 resection (n = 19) was significantly longer than for those who did not (3-year OS: 71.4% vs. 30.1%). The estimated 1-year PFS was 50.6%, and the 3-year PFS was 39.6%. The PFS for R0 was significantly longer than for non-R0 (3-year PFS: 61.3% vs 25.0%). Recurrence or progression at the primary site was observed in 31% of the non-R0 group. The rate of distant metastasis did not differ significantly between the non-R0 and R0 groups (21% vs 16%). Conclusions: Long-term follow-up evaluation confirmed that DCF chemoselection aimed at CS is feasible and promising in terms of survival for patients with locally advanced esophageal cancer.

AB - Background: A multicenter phase 2 trial analysed chemoselection with docetaxel plus 5-fluorouracil and cisplatin (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for locally advanced unresectable esophageal cancer. This study presents updated 3-year analyses to further characterize the impact of DCF-ICT followed by CS. Methods: Esophageal cancer patients with clinical T4 disease, unresectable supraclavicular lymph node metastasis, or both were eligible for this study. The treatment starts with DCF-ICT, followed by CS if the cancer is resectable, or by concurrent chemoradiation if it is not resectable. This updated analysis presents 3-year overall survival (OS), 3-year progression-free survival (PFS), and pattern of relapse. Results: The median follow-up period for the patients surviving without death was 39.3 months. The estimated 1-year OS was 66.7%, and the lower limit of the 80% confidence interval (CI) was 54.6%. The estimated 3-year OS was 46.6% (95% CI 34.2–63.5%). The OS for the patients who underwent R0 resection (n = 19) was significantly longer than for those who did not (3-year OS: 71.4% vs. 30.1%). The estimated 1-year PFS was 50.6%, and the 3-year PFS was 39.6%. The PFS for R0 was significantly longer than for non-R0 (3-year PFS: 61.3% vs 25.0%). Recurrence or progression at the primary site was observed in 31% of the non-R0 group. The rate of distant metastasis did not differ significantly between the non-R0 and R0 groups (21% vs 16%). Conclusions: Long-term follow-up evaluation confirmed that DCF chemoselection aimed at CS is feasible and promising in terms of survival for patients with locally advanced esophageal cancer.

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