Long-term survival based on pathologic response to neoadjuvant therapy in esophageal cancer
| Autor: | Bach Ardalan, Gregory Tiesi, Gustavo A. Rubio, Alan S. Livingstone, Michael H. Berger, Meredith A. Gunder, Dido Franceschi, Wungki Park |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
Adult Male Esophageal Neoplasm medicine.medical_specialty Databases Factual Esophageal Neoplasms medicine.medical_treatment Adenocarcinoma 03 medical and health sciences 0302 clinical medicine Neoadjuvant treatment Internal medicine Medicine Humans 030212 general & internal medicine Stage (cooking) Neoadjuvant therapy Aged Neoplasm Staging Retrospective Studies Chemotherapy business.industry Chemoradiotherapy Adjuvant Esophageal cancer Middle Aged medicine.disease Survival Analysis Neoadjuvant Therapy Esophagectomy Regimen Treatment Outcome Chemotherapy Adjuvant 030220 oncology & carcinogenesis Carcinoma Squamous Cell Surgery Female business Follow-Up Studies |
| Zdroj: | The Journal of surgical research. 216 |
| ISSN: | 1095-8673 |
| Popis: | Neoadjuvant treatment is standard for locally advanced esophageal cancer. However, whether the addition of radiation to neoadjuvant regimen improves survival remains unclear. The aim of this study was to compare survival in locally advanced esophageal cancer treated with neoadjuvant chemotherapy versus chemoradiation.A prospectively maintained database of esophagectomies (1999-2012) was analyzed. We identified 297 patients with locally advanced esophageal cancer that underwent either neoadjuvant chemotherapy (n = 231) or chemoradiation (n = 66) followed by esophagectomy. Pretreatment and pathologic staging were compared to assess response. Overall survival was recorded.Most patients in the chemotherapy and chemoradiation groups had pretreatment stage III disease (66.7% versus 65.2%; P = 0.44). Median follow-up was 79.3 and 64.9 mo for chemotherapy and chemoradiation cohorts, respectively. Complete response rate was higher in chemoradiation than chemotherapy groups (30.3% versus 13.8%; P 0.001). Overall survival was similar between complete responders in both groups (median not reached versus 121.1 mo; chemotherapy versus chemoradiation). However, partial responders in the chemotherapy cohort had improved median survival (147.2 mo) versus those in the chemoradiation cohort (83.7 mo, P 0.03). Within the chemotherapy-only group, partial responders had improved survival compared with nonresponders (P = 0.041); however, there was no difference in survival between partial and complete responders (P = 0.36).In patients undergoing esophagectomy for locally advanced esophageal cancer, neoadjuvant chemotherapy was associated with an equivalent overall survival, when compared with neoadjuvant chemoradiotherapy. Adding neoadjuvant radiation may enhance complete response rates but does not appear to be associated with improved survival. |
| Databáze: | OpenAIRE |
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