Significance of Neoadjuvant Downstaging in Carcinoma of Esophagus and Gastroesophageal Junction
| Autor: | Sivesh K. Kamarajah, Alexander W. Phillips, M Navidi, Arul Immanuel, S. M. Griffin, Nick Hayes, S Wahed |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Gastroenterology 03 medical and health sciences 0302 clinical medicine Stomach Neoplasms Surgical oncology Internal medicine medicine Carcinoma Humans Stage (cooking) Esophagus Thoracic Oncology Neoadjuvant therapy Aged Neoplasm Staging Retrospective Studies business.industry Middle Aged Esophageal cancer medicine.disease Neoadjuvant Therapy Esophagectomy Treatment Outcome medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Adenocarcinoma Female 030211 gastroenterology & hepatology Surgery Lymphadenectomy Esophageal Squamous Cell Carcinoma Esophagogastric Junction business |
| Zdroj: | Annals of Surgical Oncology |
| ISSN: | 1534-4681 1068-9265 |
| Popis: | Objective To determine the impact of downstaging on outcomes in esophageal cancer, the prognostic value of clinical and pathological stage, and the difference in survival in patients with similar pathological stages with and without neoadjuvant treatment. Background There is little data evaluating adenocarcinoma and squamous cell carcinoma (SCC) and difference in outcomes for similar pathological stage with and without neoadjuvant treatment. Patients and Methods Consecutive patients with esophageal cancer from a single center were evaluated. Patients with esophageal adenocarcinoma or SCC treated with transthoracic esophagectomy and two-field lymphadenectomy were included. Comparison of outcomes with those primarily treated with surgery was made. The cTNM and ypTNM 8th edition was used. Results This study included 992 patients, of whom 417 received surgery alone and 575 received neoadjuvant therapy and surgery. In the neoadjuvant group, 7 (1%) had cTNM stage 2 and 418 (73%) had cTNM stage 3. Downstaging rates were similar between adenocarcinoma and SCC (54% vs. 61%, p = 0.5). Downstaging was associated with longer survival than patients with no change (adenocarcinoma, median: 82 vs. 26 months, p p Conclusions Pathological stage provides a better estimate of prognosis compared with clinical stage. Downstaged patients may have an improved outcome over those with comparable pathological stage who did not receive neoadjuvant treatment. |
| Databáze: | OpenAIRE |
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