Factors affecting survival in operated squamous cell esophagus cancer

Purpose: Squamous cell cancer (SCC) of esophagus is an extremely fatal malignancy that is relatively rare among gastrointestinal system malignancies. The aim of this study was to investigate the factors affecting survival in operated esophageal SCC patients. Materials and Methods: Between 2004-2019, Van Yüzüncü Yıl University Dursun Odabaşı Medical Center was included in the study as a follow-up due to SCC. Patients who were 18 years or older and operated without any metastatic stage were included in the study. Results: The study included 110 patients (38 (%34.5) male and 72 (%65.5) female). The median age of the patients was 54 (26-77) years. Initially, 39 (%35.5) patients were clinical lymph node positive and 71 (%64.5) patients were negative. 35 (%31.8) patients underwent surgery after neoadjuvant chemoradiotherapy (NACRT) and 75 (%68.2) patients underwent direct surgery without NACRT. Five-year overall survival (GCP) was %84.4 in patients who underwent surgery after NACRT, and %59.2 in those who underwent direct surgery. Median overall survival (GSK) was significantly longer in patients who underwent surgery after NACRT (log rank p = 0.003). Survival was statistically significantly different (p <0.040) according to tumor response in patients who underwent surgery after NACRT. (p = 0.018), advanced pathologic stage (p = 0.001) and adjuvant treatment (p = 0.036) adversely affected survival, whereas NACRT (p = 0.003) had a positive effect on survival. In multivariate analysis, advanced pathologic stage (p = 0.002) adversely affected survival, whereas NACRT administration (p = 0.031) positively affected survival. Discussion: In our study, the survival rate was significantly shortened as the pathological stage increased in operated esophageal SCC. However, administration of NACRT significantly prolonged survival. In our study, survival was significantly prolonged as the pathological response increased in patients treated with NACRT. Conclusion: We suggest that NACRT should be given before surgery especially in locally advanced SCLC. We also think that NACRT response can be used as a good parameter for survival. These results should be supported by profective clinical studies.