Morbidity and mortality after surgery for cancer of the oesophagus and gastro-oesophageal junction: A randomized clinical trial of neoadjuvant chemotherapy vs. neoadjuvant chemoradiation. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Klevebro, F.; Johnsen, G.; Johnson, E.; Viste, A.; Myrnäs, T.; Szabo, E.; Jacobsen, A.-B.; Friesland, S.; Tsai, J.A.; Persson, S.; Lindblad, M.; Lundell, L.; Nilsson, M.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 7(2015:Jul.)
• Page Start: 920
• Page End: 926
• Publication Date: 2015-07
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2015.03.226
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Objective</title> <p id="abspara0010">To compare the incidence and severity of postoperative complications after oesophagectomy for carcinoma of the oesophagus and gastro-oesophageal junction (GOJ) after randomized accrual to neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT).</p> </sec> <sec> <title id="sectitle0020">Background</title> <p id="abspara0015">Neoadjuvant therapy improves long-term survival after oesophagectomy. To date, evidence is insufficient to determine whether combined nCT, or nCRT alone, is the most beneficial.</p> </sec> <sec> <title id="sectitle0025">Methods</title> <p id="abspara0020">Patients with carcinoma of the oesophagus or GOJ, resectable with a curative intention, were enrolled in this multicenter trial conducted at seven centres in Sweden and Norway. Study participants were randomized to nCT or nCRT followed by surgery with two-field lymphadenectomy. Three cycles of cisplatin/5-fluorouracil was administered in all patients, while 40 Gy of concomitant radiotherapy was administered in the nCRT group.</p> </sec> <sec> <title id="sectitle0030">Results</title> <p id="abspara0025">Of the randomized 181 patients, 91 were assigned to nCT and 90 to nCRT. One-hundred-and-fifty-five patients, 78 nCT and 77 nCRT, underwent resection. There was no statistically significant difference between the groups in the incidence of surgical or nonsurgical complications (P-value = 0.69 and 0.13, respectively). There was no 30-day mortality, while the 90-day mortality was 3% (2/78) in the nCT group and 6% (5/77) in the nCRT group (P = 0.24). The median Clavien-Dindo complication severity grade was significantly higher in the nCRT group (P = 0.001).</p> </sec> <sec> <title id="sectitle0035">Conclusion</title> <p id="abspara0030">There was no significant difference in the incidence of complications between patients randomized to nCT and nCRT. However, complications were significantly more severe after nCRT.</p> </sec> <sec> <title id="sectitle0040">Registration trial database</title> <p id="abspara0035">The trial was registered in the Clinical Trials Database (registration number <ext-link ext-link-type="unknown" id="intref0010" xlink:type="simple" xlink:href="ctgov:NCT01362127" xmlns:xlink="http://www.w3.org/1999/xlink">NCT01362127</ext-link>).</p> </sec> </abstract>