Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus

Table 5 Clinical and pathological characteristics of the 113 patients with pathological N0 stage, according to treatment n (%)

		pN0 Surgery alone 40 (35.4)	ypN0 Neoadjuvant chemotherapy and surgery 73 (64.6)	Pvalue
Preoperative status
Age (range) yr1		73.62 (56.73-85.41)	65.59 (32.77-78.43)	< 0.0001
Sex ratio (M:F)1		31 (77.5):9 (22.5)	66 (90.4):7 (9.8)	0.061
cT stage	1	13 (32.5)	0 (0)	< 0.0001
	2	17 (42.5)	9 (12.3)
	3	10 (25)	61 (83.6)
	4	0 (0)	3 (4.1)
cN stage	0	27 (67.5)	13 (17.8)	< 0.0001
	1	13 (32.5)	60 (82.2)
cM stage	0	40 (100)	71 (97.3)	0.293
	1	0 (0)	2 (2.8)
Performance status	0	3 (9.4)	16 (21.9)	0.045
	1	25 (78.1)	54 (74)
	2	4 (12.5)	3 (4.1)
ASA	1	2 (5)	6 (8.2)	0.268
	2	31 (77.5)	59 (80.8)
	3	7 (17.5)	8 (11)
O-POSSUM1		17 (14-29)	16 (12-26)	0.015
Tumour site	Middle 1/3	0 (0)	1 (1.4)	0.190
	Lower 1/3	15 (37.5)	35 (47.9)
	OGJ-S1	11 (27.5)	12 (16.4)
	OGJ-S2	8 (20)	16 (21.9)
	OGJ-S3	6 (15)	9 (12.3)
Operative outcomes
Length of operation (min)1		240 (120-360)	278 (120-471)	0.082
Blood loss (mL)1		200 (0-2200)	350 (0-3000)	0.167
Clavien Dindo Max	0	14 (35)	24 (32.9)	0.709
	1	1 (2.5)	3 (4.1)
	2	17 (42.5)	27 (37)
	3	4 (10)	10 (13.7)
	4	2 (5)	9 (12.3)
	5	2 (5)	0 (0)
Anastomotic leaks		4 (10)	7 (9.6)	0.944
Pathological outcomes
TRG 1-2		-	34 (46.6)	NA
TRG 3-5		-	39 (53.4)
pT or ypT	0	2 (5)	11 (15.1)	0.224
	1	22 (55)	20 (27.4)
	2	5 (12.5)	20 (27.4)
	3	10 (25)	24 (32.9)
	4	0 (0)	1 (1.4)
Nodal Downstaged (cN1 to p or ypN0)		15 (37.5)	61 (83.6)	< 0.0001
Nodal yield1		16 (4-49)	18 (3-52)	0.150
Resection clearance	R0	35 (87.5)	69 (94.5)	0.189
Vascular invasion		7 (17.5)	10 (13.7)	0.590
Lymphatic invasion		2 (5)	6 (8.2)	0.525
Perineural invasion		2 (5)	5 (6.8)	0.698
Maximum tumour diameter (mm)1		24 (0-50)	24 (0-110)	0.324
Morphology	Ulcer	25 (65.8)	53 (79.1)	0.135
	Polypoid	10 (26.3)	11 (16.4)
	Fungating	1 (2.6)	1 (1.5)
	Diffuse infiltrating	2 (5.3)	2 (3)
Grade	G1	4 (10)	13 (17.8)	0.811
	G2	17 (42.5)	20 (27.4)
	G3	19 (47.5)	40 (54.8)
	G4	0 (0)	0 (0)
Site of recurrence	Local	0 (0)	2 (2.7)	0.293
	Nodal	1 (2.5)	4 (5.5)	0.463
	Distant	3 (7.5)	12 (16.4)	0.182

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; NA: Not available.