International Session(Symposium)2(JSGS・JSGE・JGES)
Fri. November 3rd   14:00 - 17:00   Room 11: Portopia Hotel South Wing Topaz
Conversion surgery for M1 or recurrent esophageal cancer after series of multimodal treatments including immune checkpoint inhibitor
Tomoki Makino1, Hidetoshi Eguchi1, Yuichiro Doki1
1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
The standard of care for esophageal cancer (EC) patients with distant metastases is best supportive care or palliative chemotherapy. Occasionally, patients can be selected for curative treatment instead. This study aimed to evaluate patients who eventually underwent esophagectomy with/without distant metastases including abdominal paraaortic lymph nodes (PALN). Based on the multicenter retrospective database from 2005-2017, a total of 49 patients were identified to eventually receive esophagectomy. Of these patients, 42 (86%) patients received a resection of distant metastasis and 43 (86%) patients achieved R0 resection. Median overall 3- and 5-year overall survival rate (OS) was 24.7 and 21.6%, respectively. Regarding to survival classified by site of distant metastasis, 3- and 5y OS of PALN, pulmonary, liver, and bone metastasis were 31, 22, 30, and 0%, respectively. 9 patients who achieved long-term (>3 years) survival predominantly consist of R0 resection (n=9), resection of M1 disease (n=9), and pN0-1(n=7). In a different far-advanced/recurrent EC cohort treated with chemotherapy plus anti-PD-1 antibody as a first line treatment, 8 out of 22 patients (40%) have eventually received surgical resection. No serious perioperative complications or adverse events were observed. Survival data of these 8 patients will be also shown at the presentation after updating clinicopathological data.
Index Term 1: distant metastasis
Index Term 2: Immune checkpoint inhibitor
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