Christoph Springfeld1, Christiane Wiecha2, Romy Kunzmann2, Ulrike Heger2, Wilko Weichert3, Rupert Langer4, Annika Stange1, Susanne Blank2, Leila Sisic2, Thomas Schmidt2, Florian Lordick5, Dirk Jäger1, Lars Grenacher6, Tom Bruckner7, Markus W Büchler2, Katja Ott8,9. 1. Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany. 2. Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany. 3. Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany. 4. Institute for Pathology, University of Bern, Bern, Switzerland. 5. University Cancer Center Leipzig, Leipzig, Germany. 6. Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany. 7. Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany. 8. Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany. katja.ott@ro-med.de. 9. Klinik für Allgemein-, Gefäß-, und Thoraxchirurgie, RoMed Klinikum Rosenheim, Rosenheim, Germany. katja.ott@ro-med.de.
Abstract
BACKGROUND: Perioperative chemotherapy improves survival in patients with advanced esophagogastric cancer, but the optimal treatment regimen remains unclear. More intensive chemotherapy may improve outcome, but also increase toxicity and complications. METHODS: A total of 843 patients were included in this retrospective study and stratified in 4 groups: doublet therapy with cisplatin or oxaliplatin and 5-fluorouracil (groups A/B) or triplet therapy with additional epirubicin or taxane (groups C/D). The influence of the different neoadjuvant chemotherapy regimens on response, prognosis, and complications was assessed. RESULTS: Clinical and pathological response were associated with longer overall survival (OS; p < 0.001). No significant differences regarding response or OS were found, but there was a trend toward better outcome in group D (taxane-containing triplet). In the subgroup of 669 patients with adenocarcinomas of the esophagogastric junction (AEG), patients who had received taxane-containing regimens had a significantly longer OS (p = 0.037), but taxane use was not an independent factor in multivariate analysis. Triple therapy with taxanes did not result in a higher complication rate or postoperative mortality. CONCLUSIONS: Although no superior neoadjuvant chemotherapy regimen was identified for patients with esophagogastric adenocarcinoma, taxane-containing regimens should be further investigated in randomized trials, especially in patients with AEG tumors.
BACKGROUND: Perioperative chemotherapy improves survival in patients with advanced esophagogastric cancer, but the optimal treatment regimen remains unclear. More intensive chemotherapy may improve outcome, but also increase toxicity and complications. METHODS: A total of 843 patients were included in this retrospective study and stratified in 4 groups: doublet therapy with cisplatin or oxaliplatin and 5-fluorouracil (groups A/B) or triplet therapy with additional epirubicin or taxane (groups C/D). The influence of the different neoadjuvant chemotherapy regimens on response, prognosis, and complications was assessed. RESULTS: Clinical and pathological response were associated with longer overall survival (OS; p < 0.001). No significant differences regarding response or OS were found, but there was a trend toward better outcome in group D (taxane-containing triplet). In the subgroup of 669 patients with adenocarcinomas of the esophagogastric junction (AEG), patients who had received taxane-containing regimens had a significantly longer OS (p = 0.037), but taxane use was not an independent factor in multivariate analysis. Triple therapy with taxanes did not result in a higher complication rate or postoperative mortality. CONCLUSIONS: Although no superior neoadjuvant chemotherapy regimen was identified for patients with esophagogastric adenocarcinoma, taxane-containing regimens should be further investigated in randomized trials, especially in patients with AEG tumors.
Authors: Leila Sisic; Moritz J Strowitzki; Susanne Blank; Henrik Nienhueser; Sara Dorr; Georg Martin Haag; Dirk Jäger; Katja Ott; Markus W Büchler; Alexis Ulrich; Thomas Schmidt Journal: Gastric Cancer Date: 2017-07-24 Impact factor: 7.370
Authors: H Nienhüser; S Blank; L Sisic; R Kunzmann; U Heger; K Ott; M W Büchler; T Schmidt; A Ulrich Journal: Chirurg Date: 2017-04 Impact factor: 0.955
Authors: Petra Ganschow; Lena Hofmann; Sebastian Stintzing; Volker Heinemann; Martin Angele; Jens Werner; Christoph Schulz Journal: J Gastrointest Surg Date: 2020-02-10 Impact factor: 3.452
Authors: Olivia Adams; Félice A Janser; Bastian Dislich; Sabina Berezowska; Magali Humbert; Christian A Seiler; Dino Kroell; Julia Slotta-Huspenina; Marcus Feith; Katja Ott; Mario P Tschan; Rupert Langer Journal: PLoS One Date: 2018-06-13 Impact factor: 3.240