Effects of Neoadjuvant 5-Fluorouracil and Cisplatin Therapy in Patients with Clinical Stage II/III Esophageal Squamous Cell Carcinoma

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Abstract
Background: Neoadjuvant chemotherapy (NAC) with 5-fluorouracil and cisplatin (FP) has been administered to patients with clinical stage II or III esophageal squamous cell carcinoma (ESCC). We aimed to confirm the clinical efficacy and outcomes of NAC with FP. Patients and Methods: The clinicopathological features and survival of 152 patients with clinical stage II/III ESCC who received NAC with FP followed by radical esophagectomy were analyzed. Results: The R1/2 resection rate was higher (p=0.06) and the high histological response rate was significantly lower (p=0.05) in those with clinical stage III disease. Invasion depth significantly improved in those with less than cT3 (17/30. 57%), but did not in more invasive cases (35/122, 29%) (p=0.004). T Factor was frequently improved in those with clinical stage II (p=0.08). Five-year survival rates in clinical stage II and III were 73% and 41%, respectively. A multivariate analysis identified clinical stage (p=0.01) and residual tumor (p<0.01) as independent prognostic factors. Conclusion: NAC with FP is effective for patients with clinical stage II ESCC, while its potency may be lower for those with clinical stage III or cT3 disease.

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