Universität zu Köln

Schroeder, Wolfgang, Ghadimi, Markus P. H., Schloesser, Hans, Loeser, Heike, Schiller, Petra ORCID: 0000-0002-9957-1465, Zander, Thomas, Gebauer, Florian, Fuchs, Hans, Quaas, Alexander and Bruns, Christiane J. (2022). Long-Term Outcome After Histopathological Complete Response with and Without Nodal Metastases Following Multimodal Treatment of Esophageal Cancer. Ann. Surg. Oncol., 29 (7). S. 4419 - 4429. NEW YORK: SPRINGER. ISSN 1534-4681

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Abstract

Background This study analyzed the long-term survival after pathological complete response (pCR) with and without nodal metastases and associated recurrence following multimodal treatment of esophageal cancer. The recurrence pattern after pCR is of importance for different postoperative surveillance strategies. Methods A cohort of 890 patients with esophageal cancer received neoadjuvant therapy followed by transthoracic esophagectomy. Only patients with pCR of the primary tumor with and without nodal metastasis were analyzed. A clinicopathological database was set up and completed with long-term follow up information on recurrent disease. Results The specimen of 201 patients (23%) demonstrated pCR, 84% without (ypT0N0) and 16% with residual nodal disease (ypT0N+). For ypT0N0 patients, the 5-year overall survival was significantly higher than for patients with metastatic nodes (77% vs. 24%) (p < 0.0001). Sixty-eight percent of patients had no evidence of tumor recurrence, whereas 32% had proven relapse. For patients with and without tumor recurrence, 5-year survival rates were 14% and 93%, respectively (p < 0.0001). For patients with recurrent disease, median survival time was 27 for locoregional, 44 for distant, and 24 months for combined recurrence (p = 0.302). In the multivariable Cox-regression analysis, node-positive disease predicted both locoregional and metastatic recurrence. Conclusions Pathological CR offers long-term survival in patients without nodal metastases but outcome significantly deteriorates with the presence of nodal metastases. Follow-up recommendations may therefore be adopted in patients with pCR. Furthermore, watch-and-wait surveillance strategies with suspected clinical complete response have to be considered with caution.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Ghadimi, Markus P. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schloesser, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Loeser, Heike UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiller, Petra UNSPECIFIED orcid.org/0000-0002-9957-1465 UNSPECIFIED Zander, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebauer, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Quaas, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-659515
DOI:	10.1245/s10434-022-11700-3
Journal or Publication Title:	Ann. Surg. Oncol.
Volume:	29
Number:	7
Page Range:	S. 4419 - 4429
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1534-4681
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PREOPERATIVE CHEMORADIOTHERAPY; RECURRENCE; SURVIVAL; SURGERY; CHEMORADIATION; ADENOCARCINOMA; MULTICENTER; REGRESSION; CARCINOMA; PATTERNS Multiple languages Oncology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65951