BACKGROUND: Esophagectomy remains the standard treatment for resectable esophageal cancer, but the cure rate is low. Neoadjuvant therapy has been tried in attempts to prolong survival and reduce tumor recurrence. The aim of this study was to assess the surgical outcomes with and without neoadjuvant treatment for resectable esophageal cancer in a population-based setting. METHODS: All 1,155 patients treated with esophagectomy for esophageal cancer in Sweden in 1987 through 2000 with or without neoadjuvant therapy were identified and followed up in nationwide registers up to 18 October 2004. Tumor characteristics and response to neoadjuvant treatment were obtained from histopathological reports. Hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for potential confounding factors were calculated by a Cox proportional hazards regression model. RESULTS: Overall survival was similar in the groups with and without neoadjuvant therapy (adjusted HR 0.99, 95% CI 0.86-1.16). The 3-year survival rates were 34.6% and 32.0%, respectively. Survival was better among the 27.6% of the neoadjuvant group with a complete histopathological response (HR 0.71, 95% CI 0.53-0.94) compared with the surgery only group. Patients without complete response to neoadjuvant therapy had seemingly poorer survival (HR 1.10, 95% CI 0.94-1.29). CONCLUSIONS: Surgical outcomes with and without neoadjuvant therapy were equivalent. Only patients with a complete histopathological response after neoadjuvant treatment had better survival.
BACKGROUND: Esophagectomy remains the standard treatment for resectable esophageal cancer, but the cure rate is low. Neoadjuvant therapy has been tried in attempts to prolong survival and reduce tumor recurrence. The aim of this study was to assess the surgical outcomes with and without neoadjuvant treatment for resectable esophageal cancer in a population-based setting. METHODS:All 1,155 patients treated with esophagectomy for esophageal cancer in Sweden in 1987 through 2000 with or without neoadjuvant therapy were identified and followed up in nationwide registers up to 18 October 2004. Tumor characteristics and response to neoadjuvant treatment were obtained from histopathological reports. Hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for potential confounding factors were calculated by a Cox proportional hazards regression model. RESULTS: Overall survival was similar in the groups with and without neoadjuvant therapy (adjusted HR 0.99, 95% CI 0.86-1.16). The 3-year survival rates were 34.6% and 32.0%, respectively. Survival was better among the 27.6% of the neoadjuvant group with a complete histopathological response (HR 0.71, 95% CI 0.53-0.94) compared with the surgery only group. Patients without complete response to neoadjuvant therapy had seemingly poorer survival (HR 1.10, 95% CI 0.94-1.29). CONCLUSIONS: Surgical outcomes with and without neoadjuvant therapy were equivalent. Only patients with a complete histopathological response after neoadjuvant treatment had better survival.
Authors: M Gignoux; A Roussel; B Paillot; M Gillet; P Schlag; J P Favre; O Dalesio; M Buyse; N Duez Journal: World J Surg Date: 1987-08 Impact factor: 3.352
Authors: J F Bosset; M Gignoux; J P Triboulet; E Tiret; G Mantion; D Elias; P Lozach; J C Ollier; J J Pavy; M Mercier; T Sahmoud Journal: N Engl J Med Date: 1997-07-17 Impact factor: 91.245
Authors: S J Arnott; W Duncan; M Gignoux; D J Girling; H S Hansen; B Launois; K Nygaard; M K Parmar; A Rousell; G Spiliopoulos; L A Stewart; J F Tierney; M Wang; Z Rhugang Journal: Cochrane Database Syst Rev Date: 2000
Authors: F Fiorica; D Di Bona; F Schepis; A Licata; L Shahied; A Venturi; A M Falchi; A Craxì; C Cammà Journal: Gut Date: 2004-07 Impact factor: 23.059
Authors: K Nygaard; S Hagen; H S Hansen; R Hatlevoll; R Hultborn; A Jakobsen; M Mäntyla; H Modig; E Munck-Wikland; B Rosengren Journal: World J Surg Date: 1992 Nov-Dec Impact factor: 3.352
Authors: E Le Prise; P L Etienne; B Meunier; G Maddern; M Ben Hassel; D Gedouin; D Boutin; J P Campion; B Launois Journal: Cancer Date: 1994-04-01 Impact factor: 6.860
Authors: Matthias Schmidt; Elfriede Bollschweiler; Markus Dietlein; Stefan P Mönig; Carsten Kobe; Daniel Vallböhmer; Daniel Vallboehmer; Wolfgang Eschner; Arnulf Hölscher; Harald Schicha Journal: Eur J Nucl Med Mol Imaging Date: 2008-12-19 Impact factor: 9.236
Authors: Oliver Groene; Georgina Chadwick; Stuart Riley; Richard H Hardwick; Tom Crosby; Kimberley Greenaway; William Allum; David A Cromwell Journal: BMC Res Notes Date: 2014-01-10
Authors: Osama Moussa; Ricky Harminder Bhogal; George Malietzis; Charlotte Fribbens; Naureen Starling; Marco Gerlinger; David Watkins; Ian Chau; Sheela Rao; David Cunningham; William H Allum; Asif Chaudry; Sacheen Kumar Journal: BJS Open Date: 2022-01-06