Aaron U Blackham1, Binglin Yue2, Khaldoun Almhanna1, Nadia Saeed1, Jacques P Fontaine1, Sarah Hoffe3, Ravi Shridhar3, Jessica Frakes3, Domenico Coppola4,5,6, Jose M Pimiento1. 1. Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida. 2. Department of Biostatistics, Moffitt Cancer Center and Research Institute, Tampa, Florida. 3. Department of Radiation Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida. 4. Department of Anatomic Pathology, Moffitt Cancer Center and Research Institute, Tampa, Florida. 5. Department of Tumor Biology, Moffitt Cancer Center and Research Institute, Tampa, Florida. 6. Program of Chemical Biology & Molecular Medicine, Moffitt Cancer Center and Research Institute, Tampa, Florida.
Abstract
BACKGROUND: The prognostic significance of residual nodal disease in otherwise complete pathologic responders (ypT0N+) to neoadjuvant chemoradiation (nCRT) for esophageal cancer is unknown. METHODS: ypT0N+ responders were identified from a single institution database of esophageal cancer patients undergoing esophagectomy and were compared to patients without locoregional disease (ypT0N0) and to non-complete responders (ypT+). RESULTS: Out of 487 patients, 196 ypT0N0 and 14 ypT0N+ patients were identified. Pre-treatment stage was similar between ypT0N0 and ypT0N+ patients: 66% versus 73% of patients had uT3 disease (P = 0.50) and 76% versus 55% had nodal involvement (P = 0.49), respectively. Locoregional recurrence (43%) was more common in ypT0N+ patients. Median overall survival (OS) was worse in ypT0N+ patients (14.8 months) compared to ypT0N0 patients (92.2 months) and ypT+ patients (38.0 months, P < 0.001). Median OS of ypT0N+ patients was similar to ypT+ stage II (29.6 months, P = 0.84) and stage III (27.5 months, P = 0.95) disease. No difference in median OS existed in patients with residual nodal disease (n = 163) based on local response (14.8 months in ypT0N+ and 22.5 months in ypT+N+ patients, P = 0.55). CONCLUSIONS: Residual nodal disease in esophageal cancer patients with complete response in the primary tumor following nCRT portends a poor prognosis and behaves similar to pathologic stage II/III disease.
BACKGROUND: The prognostic significance of residual nodal disease in otherwise complete pathologic responders (ypT0N+) to neoadjuvant chemoradiation (nCRT) for esophageal cancer is unknown. METHODS: ypT0N+ responders were identified from a single institution database of esophageal cancerpatients undergoing esophagectomy and were compared to patients without locoregional disease (ypT0N0) and to non-complete responders (ypT+). RESULTS: Out of 487 patients, 196 ypT0N0 and 14 ypT0N+ patients were identified. Pre-treatment stage was similar between ypT0N0 and ypT0N+ patients: 66% versus 73% of patients had uT3 disease (P = 0.50) and 76% versus 55% had nodal involvement (P = 0.49), respectively. Locoregional recurrence (43%) was more common in ypT0N+ patients. Median overall survival (OS) was worse in ypT0N+ patients (14.8 months) compared to ypT0N0 patients (92.2 months) and ypT+ patients (38.0 months, P < 0.001). Median OS of ypT0N+ patients was similar to ypT+ stage II (29.6 months, P = 0.84) and stage III (27.5 months, P = 0.95) disease. No difference in median OS existed in patients with residual nodal disease (n = 163) based on local response (14.8 months in ypT0N+ and 22.5 months in ypT+N+ patients, P = 0.55). CONCLUSIONS: Residual nodal disease in esophageal cancerpatients with complete response in the primary tumor following nCRT portends a poor prognosis and behaves similar to pathologic stage II/III disease.
Authors: Nadia A Saeed; Eric A Mellon; Kenneth L Meredith; Sarah E Hoffe; Ravi Shridhar; Jessica Frakes; Jacque-Pierre Fontaine; Jose M Pimiento; Nishi Kothari; Khaldoun Almhanna Journal: J Gastrointest Oncol Date: 2017-10
Authors: Rebecca A Carr; Caitlin Harrington; Elvira Vos; Manjit S Bains; Matthew J Bott; James M Isbell; Bernard J Park; Smita Sihag; David R Jones; Daniela Molena Journal: Ann Thorac Surg Date: 2021-09-10 Impact factor: 5.102
Authors: Lieven Peter Depypere; Gil Vervloet; Toni Lerut; Johnny Moons; Gert De Hertogh; Xavier Sagaert; Willy Coosemans; Hans Van Veer; Philippe Robert Nafteux Journal: J Thorac Dis Date: 2018-05 Impact factor: 2.895
Authors: Smita Sihag; Tamar Nobel; Meier Hsu; Kay See Tan; Rebecca Carr; Yelena Y Janjigian; Laura H Tang; Abraham J Wu; Matthew J Bott; James M Isbell; Manjit S Bains; David R Jones; Daniela Molena Journal: Ann Surg Date: 2020-11-17 Impact factor: 13.787