Real-world Scenario: CROSS Regimen as Preoperative Therapy for Oesophageal Squamous Cell Carcinoma.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Ian Y H WongSimon Law

Abstract

Preoperative chemoradiation (CROSS regimen) has been widely adopted worldwide. The survival advantage imparted is especially impressive for oesophageal squamous cell carcinoma (OSCC). This study aimed at investigating the efficacy of the CROSS regimen in real-world scenario. This is a retrospective study of all patients with OSCC intended for preoperative treatment using the CROSS regimen during 2012-2017. Patients were divided into two groups: those within the selection criteria in the CROSS trial and those beyond criteria, namely age > 75 years old, tumour length > 8 cm or clinical M1 stage of lymph node involvement (AJCC 6th edition). Clinical outcome and survival data were compared. Eighty-eight patients were included. There were 46 patients in the "CROSS eligible" group and 42 in the "CROSS ineligible" group. By intention-to-treat, the estimated median survival was 24.2 months vs. 12.7 months, respectively (p = 0.047). The results were much inferior compared to that published in the original CROSS trial. Univariable and multivariable analyses showed tumour length and resectability as independent variables affecting survival. In a real-world scenario, the clinical outcome remains suboptimal and the excellent results in the ...Continue Reading

References

Sep 1, 1994·Annals of Surgery·H AkiyamaY Kajiyama
Nov 23, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Simon LawJohn Wong
Jun 1, 2012·The New England Journal of Medicine·P van HagenUNKNOWN CROSS Group
Oct 8, 2016·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
Jun 29, 2018·Clinical Epidemiology·Qiao-Li WangJesper Lagergren
Aug 9, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Hong YangUNKNOWN AME Thoracic Surgery Collaborative Group
Dec 16, 2018·Best Practice & Research. Clinical Gastroenterology·Ian Wong, Simon Law

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