title: Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis.
abstract: BACKGROUND
  Neoadjuvant chemotherapy (NAC) with CF (cisplatin/5-FU) was demonstrated to improve survival of clinical stage II/III (cStage II/III) esophageal squamous cell carcinoma (ESCC), however prognostic outcome remains unsatisfactory. We have recently reported preliminary potentiality of short-term survival benefit by NAC with DCF (docetaxel/cisplatin/5-FU).
  
  
  METHODS
  Thirty-eight ESCC patients who underwent DCF NAC between 2009 and 2012 were investigated for prognosis with a median follow-up period of 49 months as compared to those with CF NAC.
  
  
  RESULTS
  (1) ESCC patients with DCF NAC showed 66% of 3-year progression-free survival (PFS), which is significantly superior to that of CF NAC (38%) (p = 0.018). ESCC patients with DCF NAC showed 79% of 3-year overall survival (OS), which is marginally significantly superior to that of CF NAC (65%) (p = 0.093). (2) The multivariate Cox proportional hazards model revealed that DCF NAC was an independent prognostic factor for PFS (p = 0.0013) and OS (p = 0.047), respectively, when adjusted for patient sex, age, cT, cN, and preoperative borderline resectability. (3) Patients with more advanced stage were rather frequently included in DCF NAC than in CF NAC, however there was no significant difference. Nevertheless, propensity score (PS) to predict DCF NAC was significantly higher than CF NAC (p = 0.019). (4) Both NAC and PS were again applied to the multivariate Cox proportional hazards model, and DCF NAC was the only remnant prognostic indicator for PFS (p = 0.0044) and OS (p = 0.063).
  
  
  CONCLUSIONS
  Prognosis may be significantly improved in cStage II/III ESCC patients who underwent DCF NAC than those with CF NAC.
authors: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. keishi23@med.kitasato-u.ac.jp.
authors: Keishi
authors: K
authors: Yamashita
authors: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
authors: Natsuya
authors: N
authors: Katada
authors: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
authors: Hiromitsu
authors: H
authors: Moriya
authors: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
authors: Kei
authors: K
authors: Hosoda
authors: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
authors: Hiroaki
authors: H
authors: Mieno
authors: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Chikatoshi
authors: C
authors: Katada
authors: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Wasaburo
authors: W
authors: Koizumi
authors: Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Keika
authors: K
authors: Hoshi
authors: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
authors: Masahiko
authors: M
authors: Watanabe
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D000077143:Docetaxel; D004812:Epidemiologic Methods; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D011379:Prognosis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
keywords: DCF; Esophageal squamous cell carcinoma; Neoadjuvant; Prognosis; Propensity score