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SHR Neuro Cancer Cardio Lipid Metab Microb

Hoeppner, J; Zirlik, K; Brunner, T; Bronsert, P; Kulemann, B; Sick, O; Marjanovic, G; Hopt, UT; Makowiec, F.
Multimodal treatment of locally advanced esophageal adenocarcinoma: which regimen should we choose? Outcome analysis of perioperative chemotherapy versus neoadjuvant chemoradiation in 105 patients.
J Surg Oncol. 2014; 109(3):287-93 Doi: 10.1002/jso.23498
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Co-authors Med Uni Graz: Brunner Thomas Baptist
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Abstract:: BACKGROUND: 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. METHODS: 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. RESULTS: 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 (P = 0.03/P = 0.08). Total or subtotal histological tumor response after neoadjuvant treatment and esophagectomy was found in 59% after neoCRT and 30% after periCTX (P < 0.01). Three- and five-year survival rates were 52%/45% for neoCRT and 68%/63% for periCTX (P = 0.05). PeriCTX was identified as an independent predictor of survival (RR2.6; 95% CI 1.3-5.1; P < 0.01). CONCLUSION: 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.
Find related publications in this database (using NLM MeSH Indexing): Actuarial Analysis - administration & dosage; Adenocarcinoma - drug therapy, mortality, pathology, radiotherapy, surgery, therapy; Adult - administration & dosage; Aged - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemoradiotherapy, Adjuvant - administration & dosage; Chemotherapy, Adjuvant - administration & dosage; Esophageal Neoplasms - drug therapy, mortality, pathology, radiotherapy, surgery, therapy; Esophagectomy - adverse effects, mortality; Female - administration & dosage; Germany - epidemiology; Hospital Mortality - administration & dosage; Humans - administration & dosage; Kaplan-Meier Estimate - administration & dosage; Male - administration & dosage; Middle Aged - administration & dosage; Multivariate Analysis - administration & dosage; Neoadjuvant Therapy - methods; Neoplasm Grading - administration & dosage; Neoplasm Staging - administration & dosage; Postoperative Complications - diagnosis, epidemiology, etiology; Proportional Hazards Models - administration & dosage; Treatment Outcome - administration & dosage
Find related publications in this database (Keywords): esophageal cancer; adenocarcinoma; esophagectomy; survival; chemotherapy; chemoradiation