Abstract
Background
Esophageal cancer tends to be malnourished due to anorexia, transit disorder, so it is important to conduct sufficient nutritional assessment and treatment. For standard treatment of neoadjuvant chemotherapy for esophageal cancer, Cisplatin + 5-fluorouracil (FP) therapy is common, but sufficient therapeutic effect has not been obtained. As a more powerful regimen, DCF therapy with Docetaxel added to FP therapy and chemoradiotherapy have been introduced. In this study, we examined pretreatment nutritional score of esophageal cancer patients who underwent neoadjuvant therapy.
Methods
We studied 105 patients undergoing preoperative treatment diagnosed as esophageal cancer or esophagogastric junctional carcinoma from July 2012 to August 2017. Esophagectomy with lymph node dissection after neoadjuvant therapy. Relationship between Glassgow Prognostic Score (GPS) and Controlling Nutrition Status Score (CONUT) score, sex, age, staging, main tumor location, adverse event, postoperative complication and tube feeding nutrition are examined.
Results
Median age was 66 years, male/female = 92/13, and cases requiring tube feeding were 29 cases. The breakdown of the clinical stage is Stage IA, B/IIA, B/IIIA, B, C/IV = 9/34/50/12. The breakdown of neoadjuvant therapy is FP/DCF/FPRT/DCFRT/other = 9/27/26/39/4. The incidences of grade 3/4 adverse events during preoperative treatment were 66 cases (63%) in 105 patients. The treatment effect is CR/PR/SD/PD = 6/41/50/8. Histopathological result is Grade 0/1a/1b/2/3 = 3/52/13/6/31. Postoperative complications were Clavien-Dindo classification Grade IIIa or more in 20 cases, in-hospital death was 1 case.CONUT score was judged to be cut-off by more than 2, there was a significant relationship between presence of tube nutrition and treatment result (P = 0.0376, 0.0231). GPS was judged to be 1 or more cutoff, there was a significant association with tube nutrition availability and histopathological result (P = 0.0019, 0.0083). There was no significant difference between occurrence of adverse events and occurrence of postoperative complications.
Conclusion
It was suggested that CONUTscore and GPS at hospitalization are useful as predictors of treatment result and histopathological result in esophageal cancer patients who undergo neoadjuvant therapy.
Disclosure
All authors have declared no conflicts of interest.
