Neoadjuvant Therapy Vs Upfront Surgery for Clinical T2N0 Esophageal Cancer: A Systematic Review

Publication date: September 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 3Author(s): Biniam Kidane, Robert J. Korst, Benny Weksler, Ashley Farrell, Gail E. Darling, Linda W. Martin, Rishindra Reddy, Inderpal S. SarkariaBackgroundThe optimal approach to clinical T2N0 (cT2N0) esophageal cancer is unclear. Our objective is to perform a systematic review investigating whether neoadjuvant therapy results in better outcomes compared with upfront surgery in cT2N0 esophageal cancer.MethodsWe performed a systematic review and meta-analysis of randomized and nonrandomized studies (1995 to 2017) comparing use of neoadjuvant therapy with upfront surgery in the treatment of cT2N0 esophageal cancer. Independent and duplicate assessment was used. All meta-analytical techniques were performed in RevMan 5.3.ResultsNine cohort studies, including 5433 patients, were included for meta-analysis. Use of neoadjuvant therapy was associated with significantly higher complete resection rates compared with upfront surgery (risk ratio, 0.67; 95% confidence interval, 0.55 to 0.81; P
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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AbstractEsophageal cancer is one of the most aggressive gastrointestinal cancers. This review focuses on eight topics within the multidisciplinary approach for esophageal cancer. As esophagectomy is highly invasive and likely to impair quality of life, the development of less invasive strategies is expected. Endoscopic resection (ER) of early esophageal cancer is a less invasive treatment for early esophageal cancer. A recent phase II trial revealed that combined ER and chemoradiotherapy (CRT) is efficacious as an esophagus-preserving treatment for cT1bN0 squamous cell carcinoma (SCC). Esophagectomy and definitive CRT are ...
Source: Surgery Today - Category: Surgery Source Type: research
Sarcopenia, the critical depletion of skeletal muscle mass, is an independent prognostic factor in several tumor entities for treatment-related toxicity and survival. In esophageal cancer, there have been conf...
Source: Radiation Oncology - Category: Cancer & Oncology Authors: Tags: Research Source Type: research
ConclusionsCombined nimotuzumab and neoadjuvant chemoradiotherapy for clinically resectable, locally advanced esophageal cancer showed a significant anticancer effect with tolerable toxicities.
Source: Cancer Chemotherapy and Pharmacology - Category: Cancer & Oncology Source Type: research
This study compared the outcomes of circular stapled anastomoses with semi-mechanical technique using a linear stapler.MethodsPerioperative data were extracted from a contemporaneously collected database of all consecutive esophagectomies for cancer with intrathoracic anastomoses performed in the Trent Oesophago-Gastric Unit between January 2015 and April 2018. Anastomotic techniques: circular stapled versus semi-mechanical, were evaluated and outcomes were compared. The primary outcome was anastomotic leak rate. Secondary outcomes included anastomotic stricture, overall complication rates, length of stay (LOS) and 30 day ...
Source: World Journal of Surgery - Category: Surgery Source Type: research
nat S Abstract Despite representing a 1% of diagnosed cancer cases in the USA and up to 5% in eastern Asia and Africa, oesophageal cancer still holds numerous questions concerning the best therapeutic management. For squamous cell carcinoma, while radiochemotherapy has proven itself to be the gold standard as part of the trimodality or alone as a definitive treatment, radiotherapy modalities are still debated especially regarding lymph node irradiation. Involved nodes irradiation was developed with the aim of maintaining clinical outcomes and enhancing quality of life but lacks grade 1 evidence. In this article, w...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
Authors: Yun JK, Lee IS, Gong CS, Kim BS, Kim HR, Kim DK, Park SI, Kim YH Abstract Background: Although robot-assisted minimally-invasive esophagectomy (RAMIE) surgeries are expanding clinically, few studies have reported patients with locally-advanced esophageal cancer who underwent neoadjuvant chemoradiation therapy (nCRT). Methods: From 2013 to 2017, 219 patients with esophageal squamous cell carcinoma underwent RAMIE and 35 of them received nCRT at our institution. During the period, 289 patients underwent conventional open esophagectomy (OE) and 111 patients underwent nCRT. We compared postoperative mortal...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Abstract BACKGROUND: Preoperative therapy followed by surgery has become the clinical standard for resectable advanced esophageal cancer. Several studies showed that neoadjuvant docetaxel/cisplatin/5-fluorouracil (DCF) resulted in a high response rate and prolonged relapse-free survival, but what constitutes appropriate additional therapy is unknown. METHODS: A total of 101 consecutive patients with cStage I B-III esophageal cancer were treated with preoperative DCF between April 2011 and December 2015. After completing 2 cycles of DCF neoadjuvant chemotherapy (NAC), esophagectomy was performed. We investigat...
Source: Oncology - Category: Cancer & Oncology Authors: Tags: Oncology Source Type: research
Publication date: September 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 3Author(s): Tara R. Semenkovich, Melanie Subramanian, Yan Yan, Wayne L. Hofstetter, Arlene M. Correa, Stephen D. Cassivi, Matthew L. Inra, Brendon M. Stiles, Nasser K. Altorki, Andrew C. Chang, Alexander A. Brescia, Gail E. Darling, Frances Allison, Stephen R. Broderick, Eric W. Etchill, Felix G. Fernandez, Ray K. Chihara, Virginia R. Litle, Juan A. Muñoz-Largacha, Benjamin D. KozowerBackgroundThe benefit of adjuvant treatment for esophageal cancer patients with positive lymph nodes after induction therapy and esophagectomy is ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusions: Neoadjuvant radiation dose impacts pathological response in terms of pMR in oesophageal cancer patients. No radiation dose-response effect was observed for pCR. Further prospective trials are needed to investigate the dose-response relation in terms of pCR. PMID: 31432736 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
Mucosal expression of PDL1 and CD8+ and CD4+ lymphocyte rate is predictive of clinical complete response after neoadjuvant CT ‐RT for SCC of the thoracic esophagus with adequate accuracy. Furthermore, recurrence/relapse after complete response is associated with high level of CD4+ T cell infiltration. AbstractBackgroundNeoadjuvant chemoradiotherapy (CTRT) can effectively downstage esophageal squamous cell carcinoma (SCC) in patients with locally advanced disease and prolonged survival have been observed in patients with a pathological complete response (ypCR).Aims and methodsThis exploratory study aimed to identify immun...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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