Eastern J Med. Ahead of Print: EJM-12258 | DOI: 10.5505/ejm.2025.12258

The Effect of Neoadjuvant Chemoradiotherapy on Pathological Stage in Locally Advanced Esophageal Cancer

Mahmut Baran Yerlikaya¹, OZTEKIN CIKMAN², Zehra AKMAN ILIK^3
1Department of General Surgery, Agri Ibrahim Cecen University, Agri, Türkiye
²Department of General Surgery, Yüzüncü Yýl University, Van, Türkiye
³Department of Medical Pathology, Yüzüncü Yýl University, Van, Türkiye

INTRODUCTION: Esophageal cancer has an increasingly high incidence and mortality rate in our region, Turkiye and the World. Although new treatment protocols are being developed day by day, there is no standard treatment protocol which is definitely accepted. This retrospective study aimed to determine the pathological complete response rates by examining the pathological material changes in patients diagnosed with locally advanced esophageal cancer and treated with trimodal therapy.
METHODS: The age, imaging modalities, preoperative and postoperative disease stages, surgical procedure, mortality, morbidity and effects of pathological specific treatment were investigated in 27 patients with locally advanced esophageal cancer who underwent neoadjuvant chemoradiotherapy than surgery at Yüzüncü Yýl University Dursun Odabaþ Medical Center between 2012-2016. In this study, patients received trimodal treatment upon a joint decision of members of the surgical oncology council.
RESULTS: There was no significant correlation between surgical procedure and mortality and morbidity. Sensitivity and specificity ratios were similar in detecting pathological response relationship with CT and PET clinical regression. 63% pathological complete response was seen in distal esophageal tumors (p=0,012) The rate of complete response with Trimodal therapy was higher in distal esophagus cancers than in other localizations. SCC has a higher pathological complete response rate.
DISCUSSION AND CONCLUSION: Although the treatment modalities are very variable and open to development, mortality in esophageal cancers is still very high. Although pathological complete response was found to be high especially in squamous cell carcinoma patients after trimodal treatment, surgery still maintains its importance in the curative treatment of locally advanced esophageal cancer.

Keywords: Trimodal Therapy, Neoadjuvant Chemoradiotherapy, Locally Advanced Esophageal Cancer, Pathological Response

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