P1.121. Overall Survival in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma Who Did Not Undergo Surgery After Neoadjuvant Chemoradiotherapy

Abstract

Abstract Topic Esophageal Cancer: Oncology/Radiation Therapy Background The standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC) typically includes neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgical resection. However, not all patients undergo surgery for several reasons. This study evaluated the outcomes in patients with locally advanced ESCC who did not undergo surgery. Methods We evaluated patients with locally advanced ESCC who underwent neoadjuvant CCRT (fluorouracil and cisplatin) without subsequent surgical resection. Patient demographics, tumor characteristics, treatment details, and survival outcomes were analyzed. Results In total, 182 patients who underwent neoadjuvant CCRT were included in the analysis. The median overall survival (OS) was 13.0 months. Among patients who did and did not undergo surgery, 30 patients who achieved a complete clinical response (cCR) to neoadjuvant CCRT but did not proceed to surgery had significantly improved outcomes (OS=5.21 years) compared to 30 patients who underwent surgery (OS=1.79 years), 12 patients refused surgery (OS=1.63 years), 58 patients had unresectable disease (OS=0.71 years), and 52 patients were unfit for surgery (OS=0.67 years). In addition, the survival analysis, including potentially confounding variables, each treatment after CCRT was significant for OS. Conclusion cCR after neoadjuvant CCRT without subsequent surgery can result in favorable outcomes in patients with locally advanced ESCC. These findings support the potential role of CCRT as an optional treatment modality in patients with a cCR.