Universität zu Köln

Vallboehmer, D., Hoelscher, Arnulf H., DeMeester, S., DeMeester, T., Salo, J., Peters, J., Lerut, T., Swisher, S. G., Schroeder, W., Bollschweiler, E. and Hofstetter, W. (2010). A Multicenter Study of Survival After Neoadjuvant Radiotherapy/Chemotherapy and Esophagectomy for ypT0N0M0R0 Esophageal Cancer. Ann. Surg., 252 (5). S. 744 - 749. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1528-1140

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Abstract

Objective: To evaluate 5-year survival of patients with locally advanced esophageal cancer (LAEC) who have undergone multimodality treatment with complete histopathologic response. Background: Patients with LAEC may obtain excellent local-regional response to multimodality therapy. The overall benefit of a complete histopathologic response, when no viable tumor is present in the surgical specimen, is incompletely understood and existing data are limited to single-center studies with relatively few patients. The aim of this multicenter study was to define the outcome of patients with complete histopathologic response after multimodality therapy for LAEC. Methods: The study population included 299 patients (229 male, 70 female; median age: 60 years) with LAEC (cT2N1M0, T3-4N0-1M0; 181 adenocarcinomas, 118 squamous carcinomas) who underwent either neoadjuvant radiochemotherapy (n = 284) or chemotherapy (n = 15) followed by esophagectomy at 6 specialized centers: Europe (3) and United States (3). All patients in the study had stage ypT0N0M0R0 after resection. Results: Esophagectomy with thoracotomy (n = 255) was more frequent than with a transhiatal approach (n = 44). The median number of analyzed lymph nodes in the surgical specimens was 20 (minimum-maximum: 1-77). Thirty-day mortality rate was 2.4% and 90-day mortality rate was 5.7%. Overall 5-year survival rate was 55%. The disease-specific 5-year survival rate was 68%, with a recurrence rate of 23.4% (n = 70; local vs distant recurrence: 3.3% vs 20.1%). Cox regression analysis identified age as the only independent predictor of survival, whereas gender, histology, type of esophagectomy, type of neoadjuvant therapy, and the number of resected lymph nodes had no prognostic impact. Conclusion: Patients with histopathologic complete response at the time of resection of LAEC achieve excellent survival.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vallboehmer, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED DeMeester, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED DeMeester, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Salo, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peters, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lerut, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Swisher, S. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofstetter, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-492888
DOI:	10.1097/SLA.0b013e3181fb8dde
Journal or Publication Title:	Ann. Surg.
Volume:	252
Number:	5
Page Range:	S. 744 - 749
Date:	2010
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1528-1140
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SQUAMOUS-CELL CARCINOMA; COMPLETE RESPONSE; GASTROESOPHAGEAL JUNCTION; CHEMORADIOTHERAPY; CHEMORADIATION; THERAPY; SURGERY; RADIOCHEMOTHERAPY; CHEMOTHERAPY; METAANALYSIS Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/49288