title: Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: a retrospective cohort study.
abstract: OBJECTIVE
  Esophageal 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.
  
  
  METHODS
  All 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.
  
  
  RESULTS
  Mean 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%.
  
  
  CONCLUSIONS
  Complete Pathological response significantly improves overall and disease free survival. It is also the predictor of long term survival.
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 164-J3 Wapda Town Phase 1, Lahore, Pakistan. Electronic address: farrukhrizwi@gmail.com.
authors.forename: Farrukh Hassan
authors.initials: FH
authors.lastname: Rizvi
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 164-J3 Wapda Town Phase 1, Lahore, Pakistan.
authors.forename: Aamir Ali
authors.initials: AA
authors.lastname: Syed
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 164-J3 Wapda Town Phase 1, Lahore, Pakistan.
authors.forename: Shahid
authors.initials: S
authors.lastname: Khattak
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 164-J3 Wapda Town Phase 1, Lahore, Pakistan.
authors.forename: Syed Shahrukh Hassan
authors.initials: SS
authors.lastname: Rizvi
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 164-J3 Wapda Town Phase 1, Lahore, Pakistan.
authors.forename: Syed Ather
authors.initials: SA
authors.lastname: Kazmi
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 164-J3 Wapda Town Phase 1, Lahore, Pakistan.
authors.forename: Muhammad Qayum
authors.initials: MQ
authors.lastname: Khan
mesh_terms: D000328:Adult; D000368:Aged; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Complete pathological response; Esophageal cancer; Neoadjuvant treatment