Abstract Purpose-: Neoadjuvant chemotherapy followed by esophagectomy is the usual approach to manage esophageal squamous cell carcinoma (ESCC). The optimal interval to operate after completion of Neoadjuvant Chemo-radiotherapy (NACRT) still remains controversial. Methods:A prospective study was conducted to observe and compare post-operative complications and pathological outcomes in patients with squamous cell carcinoma of the esophagus who underwent NACRT followed by surgery within 8 weeks or after 8 weeks of NACRT completion. The pathological complete response was assessed using Mandard tumour regression grade. Morbidity and mortality were compared and were graded using Clavien-Dindo scale. Results: The Study included 50 patients, 19 patients in within <8 week group and 31 in >8 week group study. Patients underwent thoracoscopy assisted esophagectomy with neoesophagus formation using gastric conduit. There was a significant difference between mortality between the two groups, with three mortalities in <8 week group and none in the other group (p=0.022). Postoperative complications and pathological outcomes did not have a statistically significant difference between the two groups. Conclusion: The rate of post-operative complications and pathological response in ESCC cases do not appear to be impacted by the interval between NACRT and surgery; nevertheless, early surgery was associated with a higher risk of mortality.
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Singh et al. (2024) studied this question.
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