Survival benefit of adjuvant chemotherapy following neoadjuvant therapy and oesophagectomy in oesophageal adenocarcinoma.
| Autor: | Kamarajah SK; Department of Upper Gastrointestinal Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom; Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Markar SR; Department of Surgery & Cancer, Imperial College London, London, United Kingdom; Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden., Phillips AW; Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, United Kingdom; School of Medical Education, Newcastle University, Newcastle Upon Tyne, Tyne and Wear, United Kingdom., Kunene V; Department of Clinical Oncology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom., Fackrell D; Department of Clinical Oncology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom., Salti GI; Department of General Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA; Edward-Elmhurst Health, Department of Surgical Oncology, Naperville, IL, USA., Dahdaleh FS; Department of General Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA., Griffiths EA; Department of Upper Gastrointestinal Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom; Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. Electronic address: ewen.griffiths@uhb.nhs.uk. |
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| Jazyk: | angličtina |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2022 Sep; Vol. 48 (9), pp. 1980-1987. Date of Electronic Publication: 2022 Jun 08. |
| DOI: | 10.1016/j.ejso.2022.05.014 |
| Abstrakt: | Background: The evidence assessing the additional benefits of adjuvant chemotherapy (AC) following neoadjuvant therapy (NAT; i.e. chemotherapy or chemoradiotherapy) and oesophagectomy for oesophageal adenocarcinoma (EAC) are limited. This study aimed to determine whether AC improves long-term survival in patients receiving NAT and oesophagectomy. Methods: Patients receiving oesophagectomy for EAC following NAT from 2004 to 2016 were identified from the National Cancer Data Base (NCDB). To account for immortality bias, patients with survival ≤3 months were excluded to account for immortality bias. Propensity score matching (PSM) and Cox regression was performed to account for selection bias and analyze impact of AC on overall survival. Results: Overall, 12,972 (91%) did not receive AC and 1,255 (9%) received AC. After PSM there were 2,485 who did not receive AC and 1,254 who did. After matching, AC was associated with improved survival (median: 38.5 vs 32.3 months, p < 0.001), which remained after multivariable adjustment (HR: 0.78, CI Conclusion: AC following NAT and oesophagectomy is associated with improved survival, even in node-negative and margin-negative disease. NAT response may be crucial in identifying patients who will benefit maximally from AC, and thus future research should be focused on identifying molecular phenotype of tumours that respond to chemotherapy to improve outcomes. (Copyright © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.) |
| Databáze: | MEDLINE |
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