Multimodal treatment of locally advanced esophageal adenocarcinoma: Which regimen should we choose? Outcome analysis of perioperative chemotherapy versus neoadjuvant chemoradiation in 105 patients. Issue 3 (26th November 2013)

• Record Type: Journal Article
• Authors: Hoeppner, Jens; Zirlik, Katja; Brunner, Thomas; Bronsert, Peter; Kulemann, Birte; Sick, Olivia; Marjanovic, Goran; Hopt, Ulrich Theodor; Makowiec, Frank
• Is Part Of: Journal of surgical oncology. Volume 109:Issue 3(2014:Mar. 01)
• Page Start: 287
• Page End: 293
• Publication Date: 2013-11-26
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23498
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23498-sec-0001" sec-type="section"> <title>Background</title> <p>The study was done to compare treatment and long‐term outcomes of neoadjuvant chemoradiation (neoCRT) and perioperative chemotherapy (periCTX) in patients with surgically treated esophageal adenocarcinoma.</p> </sec> <sec id="jso23498-sec-0002" sec-type="section"> <title>Methods</title> <p>An analysis of 105 patients with esophageal adenocarcinoma undergoing neoCRT (n = 58) or periCTX (n = 47) and esophagectomy between 2000 and 2012 was carried out.</p> </sec> <sec id="jso23498-sec-0003" sec-type="section"> <title>Results</title> <p>The overall median survival was 5.97 years. Postoperative morbidity and in‐hospital mortality occurred in 74%/7% of the patients the neoCRT group and in 53%/0% of the patients in the periCTX group (<italic>P</italic> = 0.03/<italic>P</italic> = 0.08). Total or subtotal histological tumor response after neoadjuvant treatment and esophagectomy was found in 59% after neoCRT and 30% after periCTX (<italic>P</italic> < 0.01). Three‐ and five‐year survival rates were 52%/45% for neoCRT and 68%/63% for periCTX (<italic>P</italic> = 0.05). PeriCTX was identified as an independent predictor of survival (RR2.6; 95% CI 1.3–5.1; <italic>P</italic> < 0.01).</p> </sec> <sec id="jso23498-sec-0004" sec-type="section"> <title>Conclusion</title> <p>A higher rate of histologic response to neoCRT compared to histologic response following the preoperative cycles of periCTX does not translate to a benefit in overall survival. PeriCTX offers a decreased incidence of treatment‐related morbidity and mortality and at least equal results in terms of survival compared to neoCRT in patients with locally advanced esophageal adenocarcinoma. <italic>J. Surg. Oncol. 2014 109:287–293</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>