The relationship between neoadjuvant therapies and postoperative infectious complications after esophagectom

Abstract

Esophagectomy for esophageal cancer is more invasive and more complicated than other gastrointestinal surgery. The limitation of esophagectomy had been discussed because of the high malignant potential of esophageal cancer, and neoadjuvant chemotherapy (CDDP＋5-FU) followed by esophagectomy has become standard therapy for cStage Ⅱ/Ⅲ esophageal cancer from the results of JCOG 9907 trial. Several reports have reported that postopera-tive infectious complications after esophagectomy worsened long-term outcomes, and the meta-analysis also re-ported that postoperative complications after esophagectomy significantly worsened long-term outcomes. There was no significant difference in the incidence of postoperative complications between the neoadjuvant chemotherapy group and the adjuvant chemotherapy group in the JCOG 9907 trial, but postoperative infectious complications after esophagectomy worsened long-term outcomes only in the neoadjuvant chemotherapy group. It is suggested that postoperative infectious complications after esophagectomy becomes serious and significantly worsens long-term outcomes once postoperative complications occur, although neoadjuvant chemotherapy does not significantly in-crease postoperative complications.