Abstract Background Neoadjuvant therapy in oesophageal cancer has enabled some patients to achieve pathological complete response (pCR) at the time of oesophagectomy, more so in squamous cell carcinoma (SCC). There is limited data regarding the trend and implications of pCR on survival. This study was performed to assess the short-term surgical and long-term survival outcomes of patients achieving pCR after neoadjuvant therapy. Methods All 235 oesophageal cancer patients who underwent neoadjuvant treatment followed by surgery at our institute between January 2013 and December 2022 were retrospectively reviewed. Patients who achieved pathological cvomplete response (pCR) were included in the study. Demographic and clinical data were retrieved from prospectively maintained electronic medical records. Surgical outcomes, recurrence pattern and survival data were analyzed using SPSS. Results Seventy-eight (33%) patients achieved pCR and were included for analysis. Median age was 58.5 years (IQR 52–63); 46 males and 32 females. Majority (97%) had SCC and 74 (95%) patients received NACTRT while 4 (5%) patients got NACT. Transthoracic oesophagectomy was performed in 74 (95%) patients and 5%underwent Ivor Lewis oesophagectomy. Post-operative morbidity (ClavienDindo 3 and above) occurred in 41 patients (53%); mortality in 5 patients (6.4%). After a median follow up of 34 months, eight patients recurred with 5 regional recurrences and 3 distal metastases. Mediastinal (3 patients) and cervical nodal (2 patients) recurrence were the most common sites. Conclusion Median time to recurrence was 12.5 months. The median overall survival of the whole cohort was 58 months and 3 year overall survival 74.2% Patients with pCR had better survival (74.2% vs 55.6%) when compared to patients with residual disease.
Thambudorai et al. (Fri,) studied this question.