title: Multimodality Treatment and Prognosis in Esophageal Squamous Cell Carcinoma Requiring Esophagectomy.
abstract: OBJECTIVE
  MuItimodality treatment improves esophageal squamous cell carcinoma (ESCC) prognosis, however the most optimal treatment still remains controversial.
  
  
  METHODS
  In 213 ESCC patients who had operation at Kitasato University Hospital between 1996 and 2007, prognosis was evaluated in terms of cStage and adjuvant therapy.
  
  
  RESULTS
  Survival outcome of with the 62 cStage I ESCC were excellent (2 recurrences) with infrequent postoperative treatment (Adj). Of 129 ESCC patients with cStage II/III, 45 patients including suspicious cT4 (cT3.5) were given neoadjuvant therapy (Neo), and pStage 0/I patients showed excellent prognosis. Of 84 cStage II/III patients not given Neo, 67 (79.8%) underwent R0 esophagectomy, among whom 20 cases had pN0 (pStage II/IIa) with 3 recurrences (15%) despite infrequent Adj. On the other hand, among the 45 cStage II/III patients with Neo, 8 pStage IIa patients exhibited poor prognosis with 5 recurrences (62.5%) as well as pStage III/IV. In pStage IIb ESCC, cStage IIa showed poorer prognosis than cStage I/IIb (P = 0.0072). Among the 21 cStage IV ESCC patients, 5 long-term survivors were experienced by multimodality treatments.
  
  
  CONCLUSIONS
  Both cStage and Neo greatly affect ESCC prognosis irrespective of identical pStage, which must be allowed for in order to determine therapeutic strategy against ESCC.
authors.forename: Keishi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Natsuya
authors.initials: N
authors.lastname: Katada
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Moriya
authors.forename: Kei
authors.initials: K
authors.lastname: Hosoda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sakuramoto
authors.forename: Shiroh
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome