Chemosensitivity of patients with recurrent esophageal cancer receiving perioperative chemotherapy

Perioperative chemotherapy (CT) and chemoradiotherapy are widely used for advanced esophageal cancer. We evaluated the chemosensitivity of patients displaying recurrent esophageal cancer after esophagectomy with perioperative CT. From the database at National Cancer Center Hospital in Tokyo, we extracted recurrent esophageal cancer cases after perioperative CT and evaluated the effectiveness of the first CT against the recurrent disease according to the duration between termination of the original perioperative CT and recurrence with treatment-free intervals (TFIs) <= 6 and > 6 months. Systemic CT for their recurrent disease was performed for 30 esophageal cancer patients after perioperative CT. All patients received 5-fluorouracil and cisplatin as perioperative CT, with relapses occurring at TFIs <= 6 months in 11 patients (eight received platinum-containing regimens and three received docetaxel for their recurrent disease) and > 6 months in 19 patients (all received platinum-containing regimens). The response rate of patients experiencing a recurrence at TFIs <= 6 and > 6 months was 0 and 37% (P = 0.029), the median progression-free survival was 2.8 and 4.8 months (log-rank P = 0.001) and the median overall survival was 6.1 and 10.2 months (log-rank P = 0.012), respectively. Recurrence at the TFI <= 6 months could represent resistance to CT, so regimens may need to be altered depending on a patient's specific TFI.