Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: A retrospective cohort study

• Patients present with locally advanced disease requiring neoadjuvant treatment.
• Despite of advance disease 45% patients had complete pathological response.
• Complete pathological response had mean survival of 62.73 months compared to 41.42 months.
• Overall mean disease free survival was 58.91 ± 5.57 months.

Background and objectivesEsophageal cancer incidence is gradually increasing worldwide. Studies have looked at the pathological stage rather than clinical stage as predictor of survival. We looked at patients with complete pathological response to compare their survival outcomes to those who had residual disease after neoadjuvant treatment.Materials and methodsAll patients with esophageal cancer who underwent neoadjuvant treatment followed by resection at our institute were retrospectively reviewed. Overall survival and disease free survival were calculated for patients with complete pathological response and compared to those with residual disease using log rank test.ResultsMean age of our patients was 51.08 years with standard deviation of 10.17 years. 39% belong to stage IIa while 5% belong to Stage IIb. 56% were Stage III. Final histopathological stage was recorded and both disease free and overall survival were calculated. 45% of our patients had complete pathological response. Patients with complete pathological response had mean survival of 62.73 months ± 17.02 compared to 41.42 months for patients who had residual disease. 5 year disease free survival was 58%.ConclusionComplete Pathological response significantly improves overall and disease free survival. It is also the predictor of long term survival.