Universität zu Köln

Favi, F., Bollschweiler, E., Berlth, F., Plum, P., Hecheler, D., Alakus, H., Semrau, R., Celik, E., Moenig, S. P., Drebber, U. and Hoelscher, A. H. (2017). Neoadjuvant chemotherapy or chemoradiation for patients with advanced adenocarcinoma of the oesophagus? A propensity score-matched study. EJSO, 43 (8). S. 1572 - 1581. OXFORD: ELSEVIER SCI LTD. ISSN 1532-2157

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Abstract

Background: Multimodal therapies are the standard of care for advanced adenocarcinomas of the oesophagus and gastro-oesophageal junction (AEG Types I and II). Only three randomised trials have compared preoperative chemotherapy with and without radiation. The results showed a small benefit for combined chemoradiation. In the meantime, newer therapy protocols are available. Aim: In a propensity-score matched study, we analysed patients with locally advanced AEG type I or II, treated with chemotherapy (FLOT-protocol) or chemoradiation (CROSS-protocol), followed by oesophagectomy, in a single high-volume centre. Patients and methods: Between 2011 and 2015, 137 patients with advanced (cT3NxcM0) adenocarcinoma received pre-operative therapy; 70% had chemoradiation (CROSS-protocol) and 30% had chemotherapy (FLOT-protocol). After propensity-score matching, 40 patients from the CROSS-group were selected for analysis. Postoperative histopathological response and prognosis were analysed. Results: The two groups were comparable according to the matching criteria age, gender, tumour location, and year of surgery. RO-resection was achieved in 97% of patients in the CROSS-group and 85% of the FLOT-group (p = 0.049). Major response of the primary tumour was evident more often in the CROSS-group (17/40 pts. 43%) versus FLOT-group (11/40 pts. 27%) as well no lymph node metastasis (ypNO = 68% versus ypNO = 40%) (p = 0.014). Prognosis were not significantly different between the two groups. In multivariate analysis, only ypN-category was an independent prognostic factor. Conclusion: Compared to FLOT-chemotherapy, neoadjuvant chemoradiotherapy with the CROSS-protocol in locally advanced adenocarcinoma AEG types I and II resulted in better response by the primary tumour and less lymph node metastasis but without superior survival. (C) 2017 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Favi, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlth, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Plum, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hecheler, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Alakus, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Semrau, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Celik, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenig, S. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Drebber, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-222837
DOI:	10.1016/j.ejso.2017.06.003
Journal or Publication Title:	EJSO
Volume:	43
Number:	8
Page Range:	S. 1572 - 1581
Date:	2017
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1532-2157
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERIOPERATIVE CHEMOTHERAPY; GASTROESOPHAGEAL JUNCTION; CANCER; SURGERY; CHEMORADIOTHERAPY; MULTICENTER; OXALIPLATIN; CARCINOMA; THERAPY; TRIAL Multiple languages Oncology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22283