TY - JOUR
T1 - Influence of preoperative chemotherapy-induced leukopenia on survival in patients with esophageal squamous cell carcinoma
T2 - exploratory analysis of JCOG9907
AU - Hara, Hiroki
AU - Mizusawa, Junki
AU - Hironaka, Shuichi
AU - Kato, Ken
AU - Daiko, Hiroyuki
AU - Abe, Tetsuya
AU - Nakamura, Kenichi
AU - Ando, Nobutoshi
AU - Kitagawa, Yuko
N1 - Funding Information:
The authors are grateful to the members of the JCOG Data Center and JCOG Operations Office for their support in preparing data management (Ms. Aya Kimura and Ms. Naoko Murata), and oversight of the study management (Dr. Haruhiko Fukuda). JCOG9907 was supported in part by a Grant-in-Aid for Cancer Research (14S-3, 14S-4, 17S-3, 17S-5, 20S-3, 20S-6) from the Ministry of Health, Labor and Welfare of Japan and by a National Cancer Center Research and Development Fund (23-A-16, 23-A-19, 26-A-4, 29-A-3). We thank Libby Cone, MD, MA of DMC Corp. for editing drafts of this manuscript.
Funding Information:
The authors are grateful to the members of the JCOG Data Center and JCOG Operations Office for their support in preparing data management (Ms. Aya Kimura and Ms. Naoko Murata), and oversight of the study management (Dr. Haruhiko Fukuda). JCOG9907 was supported in part by a Grant-in-Aid for Cancer Research (14S-3, 14S-4, 17S-3, 17S-5, 20S-3, 20S-6) from the Ministry of Health, Labor and Welfare of Japan and by a National Cancer Center Research and Development Fund (23-A-16, 23-A-19, 26-A-4, 29-A-3). We thank Libby Cone, MD, MA of DMC Corp. for editing drafts of this manuscript.
Publisher Copyright:
© 2020, The Japan Esophageal Society.
PY - 2021/1
Y1 - 2021/1
N2 - Background: The relationship between chemotherapy-induced leukopenia (CIL) and survival has not been investigated in patients undergoing preoperative chemotherapy for esophageal squamous cell carcinoma (ESCC). We analyzed the association of CIL with survival outcomes using data from JCOG9907 on the efficacy of preoperative chemotherapy for stage II/III ESCC. Methods: Preoperative chemotherapy consisted of two courses of 5-FU (800 mg/m2 days 1–5) and cisplatin (80 mg/m2 day 1) repeated every 3 weeks. Patients in the preoperative chemotherapy arm receiving at least one course of chemotherapy and undergoing subsequent surgery in JCOG9907 were divided into two subgroups: CIL (+), those with grade 2–4 leukopenia at least once during preoperative chemotherapy; and CIL (−), those with grades 0–1. The association of CIL with overall survival (OS) and progression-free survival (PFS) was analyzed. Results: Among 164 patients enrolled in JCOG9907, 152 patients were included in this analysis, 52 in CIL (+) and 100 patients in CIL (−) subgroups. The 3-year OS for CIL (+) was inferior to that for CIL (−) (48.1% vs. 73.9%); hazard ratio (HR) = 1.94 (95% CI 1.18–3.16, P <.01). For 3-year PFS, a similar tendency was observed (44.2% vs. 55.8%; HR = 1.38 (95% CI 0.88–2.17, P =.16). Multivariable analysis revealed that CIL was not an independent factor for OS (HR = 1.14, 95% CI 0.63–2.07, P =.67). Conclusion: We showed that CIL during preoperative chemotherapy might not be a prognostic factor in patients with ESCC.
AB - Background: The relationship between chemotherapy-induced leukopenia (CIL) and survival has not been investigated in patients undergoing preoperative chemotherapy for esophageal squamous cell carcinoma (ESCC). We analyzed the association of CIL with survival outcomes using data from JCOG9907 on the efficacy of preoperative chemotherapy for stage II/III ESCC. Methods: Preoperative chemotherapy consisted of two courses of 5-FU (800 mg/m2 days 1–5) and cisplatin (80 mg/m2 day 1) repeated every 3 weeks. Patients in the preoperative chemotherapy arm receiving at least one course of chemotherapy and undergoing subsequent surgery in JCOG9907 were divided into two subgroups: CIL (+), those with grade 2–4 leukopenia at least once during preoperative chemotherapy; and CIL (−), those with grades 0–1. The association of CIL with overall survival (OS) and progression-free survival (PFS) was analyzed. Results: Among 164 patients enrolled in JCOG9907, 152 patients were included in this analysis, 52 in CIL (+) and 100 patients in CIL (−) subgroups. The 3-year OS for CIL (+) was inferior to that for CIL (−) (48.1% vs. 73.9%); hazard ratio (HR) = 1.94 (95% CI 1.18–3.16, P <.01). For 3-year PFS, a similar tendency was observed (44.2% vs. 55.8%; HR = 1.38 (95% CI 0.88–2.17, P =.16). Multivariable analysis revealed that CIL was not an independent factor for OS (HR = 1.14, 95% CI 0.63–2.07, P =.67). Conclusion: We showed that CIL during preoperative chemotherapy might not be a prognostic factor in patients with ESCC.
KW - Chemotherapy-induced leukopenia
KW - Cis-platinum
KW - Esophageal cancer
KW - Fluorouracil
KW - Preoperative chemotherapy
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UR - http://www.scopus.com/inward/citedby.url?scp=85086161788&partnerID=8YFLogxK
U2 - 10.1007/s10388-020-00752-7
DO - 10.1007/s10388-020-00752-7
M3 - Article
C2 - 32514753
AN - SCOPUS:85086161788
VL - 18
SP - 41
EP - 48
JO - Esophagus
JF - Esophagus
SN - 1612-9059
IS - 1
ER -
