Clinical efficacy of preoperative neoadjuvant chemotherapy combined with laparoscopic radical surgery for locally advanced esophageal cancer

Objective: To investigate the efficacy of preoperative neoadjuvant chemotherapy combined with laparoscopic radical surgery for locally advanced esophageal cancer. Methods: A total of 136 patients with locally advanced esophageal cancer scheduled for laparoscopic radical resection were included in this study and they were divided into two groups: observation group (n = 68, preoperative neoadjuvant chemotherapy combined with laparoscopic radical surgery) and control group (n = 68, laparoscopic radical surgery). The operation related indicators, postoperative recovery profile, the incidences of postoperative complications and adverse reactions to chemotherapy, recurrence and metastasis were observed. Results: There were no statistical differences in general information, operation time, intraoperative blood loss, the number of lymph nodes dissected, the time to postoperative thoracic duct extraction, the length of postoperative hospital stay, postoperative feeding time and the incidences of postoperative complications between the two groups (all P > 0.05). There were statistical differences in the rates of postoperative lymph node metastasis, the degrees of lymph node metastasis, and surgical resection margin between the two groups (all P < 0.05). In the observation group, hair loss was the most common adverse reaction after chemotherapy, followed by gastrointestinal symptoms, and no serious adverse reaction above grade 4 occurred. The total effective rate in the observation group was 57.35%, and the total control rate was 92.65%, which were significantly higher than those in the control group (38.24%, P = 0.026; 80.88%, P = 0.040). The number of deaths, recurrence and metastasis in the observation group was lower than those in the control group respectively (all P < 0.05). Conclusion: Preoperative neoadjuvant chemotherapy combined with laparoscopic radical surgery can increase the R0 resection rate, decrease the degree and rate of lymph node metastasis, and reduce postoperative recurrence and metastasis.