Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus

Table 2 Clinical and pathological characteristics of the 218 patients operated on for esophageal and gastro-esophageal adenocarcinoma, according to treatment n (%)

Characteristic		Surgery only 82 (37.6)	Neoadjuvant chemotherapy and surgery 136 (62.4)	Pvalue
Preoperative status
Age (range)1 yr		74.32 (42.08-85.41)	63.76 (32.77-81.28)	< 0.0001
Sex ratio (M:F)1		68 (82.9):14 (17.1)	118 (86.8):18 (13.2)	0.439
cT stage	1	17 (20.7)	0 (0.0)	< 0.0001
	2	30 (36.6)	16 (16.0)
	3	34 (41.5)	114 (84.0)
	4	1 (1.2)	6 (4.4)
cN stage	0	36 (43.9)	19 (14.0)	< 0.0001
	1	46 (56.1)	117 (86.0)
cM stage	0	80 (97.6)	134 (98.5)	0.613
	1	1 (2.4)	2 (1.4)
Performance status	0	8 (11.6)	35 (25.7)	0.001
	1	51 (73.9)	96 (70.6)
	2	10 (14.5)	5 (3.7)
ASA	1	3 (3.7)	11 (8.1)	0.005
	2	56 (68.3)	106 (78.5)
	3	23 (28)	18 (13.3)
O-POSSUM		18 (12-30)	16 (12-26)	< 0.0001
Tumour site	Middle 1/3	1 (1.2)	1 (0.7)	0.418
	Lower 1/3	32 (39)	57 (41.9)
	GEJ-S1	19 (23.2)	23 (16.9)
	GEJ-S2	18 (22.0)	34 (25.0)
	GEJ-S3	12 (14.6)	20 (14.7)
Operative outcomes
Length of operation (min)1		255 (120-480)	261 (120-471)	0.409
Blood loss (mL)1		300 (0-2200)	318 (0-3000)	0.429
Clavien Dindo Max	0	26 (31.7)	53 (39.3)	0.59
	1	5 (6.1)	8 (5.9)
	2	35 (42.7)	40 (29.6)
	3	6 (7.3)	17 (12.6)
	4	6 (7.3)	17 (12.6)
	5	4 (4.9)	0 (0)
Anastomotic leaks		8 (9.8)	9 (6.7)	0.413
Pathological outcomes
pT or ypT	0	3 (3.6)	8 (5.9)	0.692
	1	23 (28)	23 (16.9)
	2	17 (20.7)	34 (25)
	3	34 (41.5)	66 (48.5)
	4	5 (6.1)	5 (3.7)
pN or ypN	0	40 (48.8)	73 (53.7)	0.758
	1	20 (24.4)	21 (15.4)
	2	11 (13.4)	25 (18.4)
	3	11 (13.4)	17 (12.5)
pM or ypM	0	82 (100)	136 (100)	1.00
Tumour regression grade	1	-	8 (5.8)	n/a
	2	-	28 (20.6)
	3	-	20 (14.7)
	4	-	45 (33.1)
	5	-	35 (25.7)
Nodal downstaged (cN1 to p or ypN1)		13 (15.9)	60 (44.1)	< 0.0001
Positive nodes1		1 (0-21)	0 (0-24)	0.789
Nodal yield1		18 (4-49)	18 (3-53)	0.242
Resection clearance	R0	65 (79.3)	110 (80.9)	0.772
Vascular invasion		24 (29.3)	41 (30.1)	0.891
Lymphatic invasion		9 (11)	22 (16.2)	0.28
Perineural invasion		8 (9.8)	20 (14.7)	0.291
Maximum tumour diameter (mm)1		25 (0-90)	25 (0-155)	0.998
Morphology	Ulcer	48 (60)	96 (74.4)	0.029
	Polypoid	22 (27.5)	23 (17.8)
	Fungating	2 (2.5)	3 (2.3)
	Diffuse infiltrating	8 (10)	7 (5.4)
Grade	G1	6 (7.3)	16 (11.8)	0.669
	G2	30 (36.6)	37 (27.2)
	G3	46 (56.1)	82 (60.3)
	G4	0 (0)	1 (0.7)
Sites of recurrence	Local	3 (3.7)	8 (5.9)	0.461
	Nodal	5 (6.1)	14 (10.4)	0.281
	Distant	18 (22.0)	44 (32.6)	0.093

Values in parentheses are percentages unless indicated.

¹Values in parentheses are range. ASA: American society of anesthesiologists classification; O-POSSUM: Oesophagogastric surgery-physiological and operative severity score for the enumeration of mortality and morbidity; GEJ-S1-3: Gastro-esophageal junction-Siewert type 1-3.