Surgical resection after neoadjuvant chemoradiation for oesophageal adenocarcinoma: what is the optimal timing?

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
David N RanneyMatthew G Hartwig

Abstract

The purpose of this study was to determine the optimal timing of surgical resection of oesophageal adenocarcinoma following neoadjuvant chemoradiotherapy (nCRT). nCRT before resection of oesophageal adenocarcinoma yields improved overall and progression-free survival. Despite the wide acceptance of tri-modal therapy, the optimal timing of surgical resection after nCRT is not well defined and existing studies are limited. Adults with Stage II/III oesophageal adenocarcinoma undergoing nCRT before surgery were identified from the National Cancer Database. Multivariable analysis using restricted cubic splines was used to identify an inflection point in clinical outcomes as a function of time between nCRT and surgery, dividing the cohort into short- and long-interval treatment groups, which were then compared. Adjusted rates of survival and margin status were compared between groups using multivariable analysis. Among 2444 patients, restricted cubic splines identified an inflection point at 56 days, dividing our cohort into 1533 short-interval and 911 long-interval patients. Long-interval patients had a higher adjusted incidence of pathologic downstaging (odds ratio 1.38, confidence interval 1.02-1.85, P = 0.04) but no difference in...Continue Reading

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Citations

Nov 5, 2019·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·F KlevebroM Nilsson
Jan 30, 2018·World Journal of Gastroenterology : WJG·Yi LiuLin Chen
Jul 24, 2020·World Journal of Gastrointestinal Oncology·Qi-Xin ShangYong Yuan
May 20, 2020·The Journal of Surgical Research·Raphael J LouieHong Jin Kim
Apr 25, 2020·The Annals of Thoracic Surgery·Kristen E RhodinThomas A D'Amico
Jul 14, 2021·Journal of Surgical Oncology·Kevin A ChenMichael O Meyers
Dec 18, 2019·The Annals of Thoracic Surgery·Zachary D HorneSushil Beriwal

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