PD07.01. Prognostic Factors in Patients Receiving Neoadjuvant DCF Chemotherapy for Esophageal Squamous Cell Carcinoma: A Supplementary Analysis of JCOG1109

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ID: 326047
2026
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Abstract
Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background JCOG1109, a multicenter phase III trial, demonstrated the survival benefit of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (DCF) in advanced esophageal squamous cell carcinoma (ESCC). In this trial, neoadjuvant DCF therapy showed a pathological complete response (pCR) rate of 16.8%. We investigated prognostic factors including pCR of this therapy. Methods Of the 601 patients enrolled in JCOG1109, this analysis included eligible patients who underwent neoadjuvant DCF followed by surgery and completed pathological evaluation. Prognostic factors of overall survival (OS) were examined using Cox regression with preoperative and combined pre- and postoperative covariates, namely preoperative clinical factors and pCR (ypT0N0M0). Predictors of pCR were assessed using logistic regression with preoperative factors including cCR (cT0N0M0). Results A total of 181 patients were eligible for the analysis. Multivariable analyses of preoperative covariates showed that performance status (PS) 1 [vs. 0; Hazard ratio (HR) 0.156, p = 0.003], serum albumin (Alb) < 4.0 g/dl [vs. ≥4.0 g/dl; HR 2.080, p = 0.021], and cT3 [vs. cT1-2; HR 2.279, p = 0.011] were significantly associated with survival. When analyzed by pre- and postoperative factors, PS 1 [HR 0.172, p = 0.005], Alb < 4.0 g/dl [HR 2.267, p = 0.010], cT3 [HR 2.091, p = 0.024], and pCR [vs. non-pCR; HR 0.149, p = 0.002] had a significant impact on survival. The 5-year OS was 93.8% / 61.4% for pCR / non-pCR, respectively. cCR [vs. non-cCR; odds ratio (OR) 6.615, p = 0.022], age ≥65 [vs. < 65; OR 2.713, p = 0.030], and cT3 [vs. cT1-2; OR 0.381, p = 0.039] were significantly associated with pCR. Conclusion In this analysis, we found that cT1-2 and high serum Alb were associated with improved survival in neoadjuvant DCF for advanced ESCC, consistent with previous reports. Moreover, pCR is newly identified as an independent prognostic factor. pCR was significantly associated with cCR, older age, and cT1-2, which may be potential predictors for pCR.
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Authors Takako Yoshii, Tomoya Yokota, Ken Kato, Ryunosuke Machida, Yoshinori Ito, Hiroyuki Daiko, Kazuo Koyanagi, Takashi Ogata, Hiroki Hara, Takeo Fujita, Tetsuya Abe, Kazuaki Harada, Takeshi Toyozumi, Yuichiro Doki, Satoshi Kamiya, Shinsuke Maeda, Kota Kawabata, Takeo Bamba, Satoru Matsuda, Hiroya Takeuchi
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.123
URL
https://doi.org/10.1093/dote/doag077.123
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