ĐÁNH GIÁ KẾT QUẢ GIẢM GIAI ĐOẠN BỆNH SAU HÓA XẠ TRỊ TÂN BỔ TRỢ TRƯỚC PHẪU THUẬT NỘI SOI CẮT THỰC QUẢN ĐIỀU TRỊ UNG THƯ THỰC QUẢN VÀ CÁC YẾU TỐ LIÊN QUAN

Abstract

Objectives: To evaluate downstaging outcomes after neoadjuvant chemoradiotherapy (nCRT) prior to minimally invasive esophagectomy (MIE) for esophageal cancer and to analyze associated factors. Methods: A combined retrospective and prospective, descriptive study was conducted on 77 patients with esophageal cancer who underwent nCRT followed by MIE at Military Hospital 103, and 108 Military Central Hospital from January 2021 to April 2026. Results: The downstaging rate was 61.0%, while 31.2% of patients had no stage change and 7.8% experienced upstaging. A total of 36.4% of patients were downstaged to stage 0-I, and 23.4% achieved pathological complete response. T and N downstaging rates were 70.1% and 54.5%, respectively, with 57.1% of patients achieving ypN0 after surgery. Univariate analysis showed that tumor location, histology, and baseline tumor invasion were associated with downstaging (p < 0.05). Multivariate analysis identified tumors located in the middle third and less advanced tumor invasion (cT0-2) as independent factors associated with downstaging (p < 0.05). Conclusion: Neoadjuvant chemotherapy followed by minimally invasive esophagectomy achieved a high rate of downstaging. Tumor location and baseline tumor invasion are predictors of downstaging.