Docetaxel, cisplatin and 5-fluorouracil adjuvant chemotherapy following three-field lymph node dissection for stage II/III N1, 2 esophageal cancer

Hashiguchi,Tadasuke; Nasu,Motomi; Hashimoto,Takashi; Kuniyasu,Tetsuji; Inoue,Hirohumi; Sakai,Noritaka; Ouchi,Kazutomo; Amano,Takayuki; Isayama,Fuyumi; Tomita,Natsumi; Iwanuma,Yoshimi; Tsurumaru,Masahiko; Kajiyama,Yoshiaki

doi:10.3892/mco.2014.320

Docetaxel, cisplatin and 5-fluorouracil adjuvant chemotherapy following three-field lymph node dissection for stage II/III N1, 2 esophageal cancer

Authors:
- Tadasuke Hashiguchi
- Motomi Nasu
- Takashi Hashimoto
- Tetsuji Kuniyasu
- Hirohumi Inoue
- Noritaka Sakai
- Kazutomo Ouchi
- Takayuki Amano
- Fuyumi Isayama
- Natsumi Tomita
- Yoshimi Iwanuma
- Masahiko Tsurumaru
- Yoshiaki Kajiyama
View Affiliations

Affiliations: Department of Esophageal and Gastroenterological Surgery, Juntendo University Hospital, Tokyo 113-8431, Japan, Cancer Treatment Center, Juntendo University Hospital, Tokyo 113-8431, Japan
Published online on: June 19, 2014 https://doi.org/10.3892/mco.2014.320
Pages: 719-724

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

To determine the efficacy of postoperative adjuvant chemotherapy with docetaxel + cisplatin + 5-fluorouracil (DCF) in lymph node metastasis-positive esophageal cancer, we retrospectively analyzed 139 patients with stage II/III (non‑T4) esophageal cancer with lymph node metastasis (1-6 nodes), who did not receive preoperative treatment and underwent three‑field lymph node dissection in the Juntendo University Hospital between December, 2004 and December, 2009. the tumors were histologically diagnossed as squamous cell carcinoma. The patients were divided into two groups, a surgery alone group (S group, 88 patients) and a group that received postoperative DCF therapy (DCF group, 51 patients). The disease-free and overall survival were compared between the groups and a multivariate analysis of prognostic factors was performed. The same analysis was performed for cases classified as N1 and N2, according to the TNM classification. There were no significant differences between the S and DCF groups regarding clinicopathological factors other than intramural metastasis and main tumor location. The presence of intramural metastasis, blood vessel invasion and the number of lymph nodes were identified as prognostic factors. The 5‑year disease-free and overall survival were 55.8 and 57.3%, respectively, in the S group and 52.8 and 63.0%, respectively, in the DCF group. These differences were not considered to be statistically significant (P=0.789 and 0.479 for disease‑free and overall survival, respectively). Although there were no significant differences in disease-free and overall survival between the S and DCF groups in N1 cases, both disease-free and overall survival were found to be better in the DCF group (54.2 and 61.4%, respectively) compared to the S group (29.6 and 28.8%, respectively) in N2 cases (P=0.029 and 0.020 for disease‑free and overall survival, respectively). Therefore, postoperative adjuvant chemotherapy with DCF was shown to improve disease-free and overall survival in moderate lymph node metastasis-positive cases (N2), suggesting that the DCF regimen may be effective as postoperative adjuvant chemotherapy for patients with lymph node metastasis from esophageal cancer.

View Figures

View References

1	Kajiyama Y and Tsurumaru M: Esophagectomy with lymph node dissection through right thoracotomy. Nihon Geka Gakkai Zasshi. 103:343–347. 2002.(In Japanese).
2	Akiyama H, Tsurumaru M, Udagawa H and Kajiyama Y: Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg. 220:364–373. 1994. View Article : Google Scholar : PubMed/NCBI
3	Kajiyama Y, Iwanuma Y, Tomita N, et al: Indication and limitation of 3-field lymph node dissection surgery for esophageal cancer from survival analysis. J Jpn Surg Assoc. 68:795–804. 2007. View Article : Google Scholar
4	Kajiyama Y, Iwanuma Y, Tomita N, et al: Current surgical treatment for esophageal cancer: Indication and limitation of 3-field lymph node dissection surgery based on survival analysis. Juntendo Med J. 53:542–551. 2007.(In Japanese).
5	Guide line for the clinical and pathologic studies on carcinoma of the esophagus. 9th edition. Japan Esophageal Society. 8:23. 1999.
6	Sobin LH, Gospodarowicz MK and Wittekind C: TNM Classification of Malignant Tumours. 7th edition. International Union Against Cancer (UICC). Wiley-Blackwell; West Sussex: 2009
7	Japanese translation of common terminology criteria for adverse events (CTCAE) version 4.0. JCOG; 2009
8	Kajiyama Y and Tsurumaru M: Preservation of right and left bronchial arteries. Gastroentrological Surg. 30:151–157. 2007.
9	Kajiyama Y and Tsurumaru M: Treatment of esophageal cancer: open vs. thoracoscopic surgery. Nihon Geka Gakkai Zasshi. 106:357–360. 2005.(In Japanese).
10	Kajiyama Y, Iwanuma Y, Tomita N, et al: Lymph node dissection along the recurrent laryngeal nerve and preservation of bronchial artery in esophageal cancer surgery. Gastroentrological Surg. 34:1–9. 2011.
11	Tsurumaru M, Kajiyama Y, Iwanuma Y, et al: Surgical and anatomical problems of the vagus nerve (recurrent laryngeal nerve) in patients with cancer of the thoracic esophagus: View of open surgery. In: 8th Japanese Research Society of Clinical Anatomy Meeting; 5. 2005
12	Kajiyama Y, Iwanuma Y, Tomita N, et al: Progress and perspective of trans-thoracic esophageal cancer surgery. Gastroentrological Surg. 35:1079–1085. 2012.
13	Kajiyama Y, Tsurumaru M, Iwanuma Y, et al: Controversies in esophageal cancer surgery. Jpn J Cancer Chemother. 30:1225–1229. 2003.(In Japanese).
14	Matsubara H: New strategy for esophageal cancer. Chiba Igaku Zasshi. 84:69–74. 2008.(In Japanese).
15	Ando N, Iizuka T, Ide H, et al: Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: A Japan Clinical Oncology group study - JCOG 9204. J Clin Oncol. 21:4592–4596. 2003. View Article : Google Scholar : PubMed/NCBI
16	Guide line on diagnosis and treatment for esophageal cancer. 2th edition. Japan Esophageal Society; 2007
17	Ajani JA, Ryan B, Rich TA, McMurtey M, Roth JA, DeCaro L, Levin B and Mountain C: Prolonged chemothrerapy for localized squamous carcinoma of the oesophagus. Eur J Cancer. 28A. pp. 880–884. 1992, View Article : Google Scholar : PubMed/NCBI
18	Hilgenberg AD, Carey RW, Wilkins EW Jr, Choi NC, Mathisen DJ and Grillo HC: Preoperative chemotherapy, surgical resection, and selective postoperative therapy for squamous cell carcinoma of the esophagus. Ann Thorac Surg. 45:357–363. 1988. View Article : Google Scholar : PubMed/NCBI
19	Kelsen D: Chemothrapy of esophageal cancer. Semin Oncol. 11:159–168. 1984.PubMed/NCBI
20	Iizuka T, Kakegawa T, Ide H, et al: Phase II evaluation of cisplatin and 5-fluorouracil in advanced squamous cell carcinoma of the esophagus:a Japanese Esophageal Oncology Group Trial. Jpn J Clin Oncol. 22:172–176. 1992.PubMed/NCBI
21	Kok TC, Van der Gaast A, Dees J, Eykenboom WM, Van Overhagen H, Stoter G, Tilanus HW and Splinter TA: Cisplatin and etoposide in oesophageal cancer: a phase II study. Rotterdam Oesophageal Tumour Study Group. Br J Cancer. 74:980–984. 1996. View Article : Google Scholar : PubMed/NCBI
22	Ilson DH, Saltz L, Enzinger P, Huang Y, Kornblith A, Gollub M, ‘Reilly E, Schwartz G, DeGroff J, Gonzalez G and Kelsen DP: Phase II trial of weekly irinotecan plus cisplatin in advanced esophageal cancer. J Clin Oncol. 17:3270–3275. 1999.PubMed/NCBI
23	Ilson DH, Ajani J, Bhalla K, Forastiere A, Huang Y, Patel P, Martin L, Donegan J, Pazdur R, Reed C and Kelsen DP: Phase II trial of paclitaxel, fluorouracil, and cisplatin in patients with advanced carcinoma of the esophagus. J Clin Oncol. 16:1826–1834. 1998.PubMed/NCBI
24	Kroep JR, Pinedo HM, Giaccone G, Van Bochove A, Peters GJ and Van Groeningen CJ: Phase II study of cisplatin preceding gemcitabine in patients with advanced oesophaeal cancer. Ann Oncol. 15:230–235. 2004. View Article : Google Scholar : PubMed/NCBI
25	Millar J, Scullin P, Morrison A, McClory B, Wall L, Cameron D, Philips H, Price A, Dunlop D and Eatok M: Phase II study of gemcitabine and cisplatin in locally advanced/metastatic oesophageal cancer. Br J Cancer. 93:1112–1116. 2005. View Article : Google Scholar : PubMed/NCBI
26	Mauer AM, Kraut EH, Krauss SA, Ansari RH, Kasza K, Szeto L and Vokes EE: Phase II trial of oxaliplatin, leucovorin and fluorouracil in patients with advanced carcinoma of the esophagus. Ann Oncol. 16:1320–1325. 2005. View Article : Google Scholar : PubMed/NCBI
27	van Meerten E, Eskens FA, van Gameren EC, Doorn L and van der Gaast A: First-line treatment with oxaliplatin and capecitabine in patients with advanced or metastatic oesophageal cancer: a phase II study. Br J Cancer. 96:1348–1352. 2007.PubMed/NCBI
28	Tsuda T and Boku N: Current realities and problems of chemotherapy for esophageal cancer. Gastroentrological Surg. 35:1117–1122. 2012.
29	Van Cutsem E, Moiseyenko VM, Tjulandin S, et al; V325 Study Group. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol. 24:4991–4997. 2006.PubMed/NCBI
30	Posner MR, Hershock DM, Blajman CR, et al: Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med. 357:1705–1715. 2007. View Article : Google Scholar : PubMed/NCBI