Introduction: We report outcomes of patients with oesophageal cancer treated with neoadjuvant
chemoradiotherapy (NACRT) plus surgery or definitive chemoradiotherapy (chemoRT) at our institution.
Methods: We retrospectively reviewed patients who underwent chemoRT from 2005 to 2017. The
primary outcome was overall survival (OS). Secondary outcomes were disease-free survival (DFS)
and toxicities.
Results: We identified 96 patients with median age of 64 years and squamous cell carcinoma in
82.3%. Twenty-nine patients (30.2%) received NACRT plus surgery, 67 patients (69.8%) received
definitive chemoRT. Median follow-up was 13.5 months. The 3/5-year OS were 26.4%/13.4%,
and 59.6%/51.6% in the definitive chemoRT and NACRT plus surgery groups, respectively. The
3/5-year DFS were 19.3%/12.3%, and 55.7%/37.2% in the definitive chemoRT and NACRT plus
surgery groups, respectively. NACRT plus surgery significantly improved OS (hazard ratio [HR]
0.40, 95% confidence interval [CI] 0.22–0.72, P<0.01) and DFS (subhazard ratio [SHR] 5.21, 95
CI 1.20–22.7, P=0.03). Multivariable analysis for OS in the definitive chemoRT group indicated
stage (1–2 vs 3–4a; HR 2.17, 95% CI 1.15–4.11, P=0.02) and feeding tube (no tube versus tube; HR
1.85, 95% CI 1.00–3.43, P=0.05) as significantly associated with OS. The cumulative incidence of local
recurrence was significantly higher in the definitive chemoRT group (SHR 5.21, 95 CI 1.2022.7,
P=0.03). Nineteen patients (65.5%) had postoperative complications.
Conclusion: NACRT plus surgery improved OS and DFS. However, in view of treatment-related
complications, careful selection of patients is warranted. With the predominant histology of our cohort
being squamous cell carcinoma (SCC), our results may be more re levant for those with SCC.
Keywords: Neoadjuvant chemoradiotherapy, oesophageal cancer, surgery