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Life sciences · Journal article
Langenbeck S Archives of Surgery · September 26, 2026
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The JCOG1109 trial proved the superiority of neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and 5-fluorouracil (DCF) to chemotherapy with cisplatin and 5-fluorouracil (CF). Concurrently, advances in immune checkpoint inhibitors (ICIs) have introduced new perioperative strategies. This study aimed to evaluate the clinical outcomes of preoperative DCF therapy and analyze risk factors for recurrence to identify the patient populations most likely to benefit from subsequent optimized perioperative treatment strategies. The subjects were esophageal cancer (EC) patients who underwent esophagectomy after NAC-DCF in Okayama University Hospital between January 2014 and December 2019. The esophageal squamous cell carcinoma (ESCC) stages included cT1-3 N0-3 M0. Recurrence patterns, overall survival (OS), and recurrence-free survival (RFS) were assessed with the log-rank test, and prognostic factors related to RFS were examined with Cox regression analysis. A total of 63 ESCC patients who underwent NAC-DCF therapy met the criteria. The mean age was 64.4 ± 6.9 years. Clinical stage was I in 1 case, II (IIA/IIB) in 17 cases, and III (IIIA/IIIB/IIIC) in 45 cases. The overall response rate for primary lesions was 65%. The 3-year recurrence-free and overall survival rates were 64.1% and 67.4%, respectively. Multivariate analysis identified stable disease (SD) after one cycle of DCF ( P = 0.004) and pathological N-factor ( P = 0.030) as significant prognostic factors. This study highlights that DCF therapy achieves outcomes comparable to clinical trials and reinforces the prognostic significance of SD after one cycle of DCF and pathological N-factor for recurrence risk. These findings provide valuable insights into subsequent optimizing perioperative treatment strategies for EC patients.