Definitive or Preoperative Chemoradiation Therapy for Esophageal Cancer: Patterns of Care and Survival Outcomes

Shao, Meng; Wong, Alice; Schwartz, David L.; Weiner, Joseph; Schreiber, David

doi:10.1016/j.athoracsur.2015.12.056

Cited by 26 publications

(25 citation statements)

References 13 publications

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“…After a radiation dose of 50 Gy to the tumor, affected lymph nodes, safety margins, and elective lymph nodes, a consecutive boost of 4-16 Gy was prescribed to tumor/affected lymph nodes (average total dose: 58.9 Gy) with reduced margins. Concomitant chemotherapy consisted of two cycles of cisplatin (25 mg/m 2 /day, Days 1-3 and Days 29-31) and either paclitaxel (135 mg/m 2 /day, Day 1 and Day 29) or 5-fluorouracil (500 mg/m 2 /day, Days 1-5 and Days [29][30][31][32][33].…”

Section: Patients Treatment and Follow-upmentioning

confidence: 99%

Combined tumor plus nontumor interim FDG‐PET parameters are prognostic for response to chemoradiation in squamous cell esophageal cancer

Zschaeck

Bütof

et al. 2020

Intl Journal of Cancer

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We have investigated the prognostic value of two novel interim 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) parameters in patients undergoing chemoradiation (CRT) for esophageal squamous cell carcinoma (ESCC): one tumor parameter (maximal standardized uptake ratio rSUR) and one normal tissue parameter (change of FDG uptake within irradiated nontumoraffected esophagus ΔSUV NTO). PET data of 134 European and Chinese patients were analyzed. Parameter establishment was based on 36 patients undergoing preoperative CRT plus surgery, validation was performed in 98 patients receiving definitive CRT. Patients received PET imaging prior and during fourth week of CRT. Clinical parameters, baseline PET parameters, and interim PET parameters (rSUR and ΔSUV NTO) were analyzed and compared to event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM). Combining rSUR and ΔSUV NTO revealed a strong prognostic impact on EFS, OS, LRC and FFDM in patients undergoing preoperative CRT. In the definitive CRT cohort, univariate analysis with respect to EFS revealed several staging plus both previously established interim PET parameters as significant prognostic factors. Multivariate analyses revealed only rSUR and ΔSUV NTO as independent prognostic factors (p = 0.003, p = 0.008). Combination of these parameters with the cutoff Additional Supporting Information may be found in the online version of this article.

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Section: Patients Treatment and Follow-upmentioning

confidence: 99%

Combined tumor plus nontumor interim FDG‐PET parameters are prognostic for response to chemoradiation in squamous cell esophageal cancer

Zschaeck

Bütof

et al. 2020

Intl Journal of Cancer

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“…However, tri-modality treatment, including esophageal resection with adjuvant chemoradiotherapy, has become commonplace with a 3-year survival reaching up to 50%. 1 , 2 Orringer and Sloan were the first to report a series of transhiatal esophagectomies with less than 10% peri-operative mortality. 3 Subsequently, with improvements in surgical technique and post-operative critical care management, the peri-operative mortality has decreased to low single digits at high volume centers.…”

Section: Introductionmentioning

confidence: 99%

Quality of life after esophageal resection

Svetanoff

McGahan

Singhal

et al. 2018

PROM

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IntroductionEsophageal resection is the primary treatment for malignant esophageal disease and the last resort for benign end-stage esophageal disease. There is a paucity of research comparing the long-term quality of life (QoL) following surgery among these two populations. The aim of this study was to examine the patient reported QoL after esophageal resection using questionnaires focusing on general well-being and esophageal-specific symptoms.MethodsA prospectively maintained database of post-operatively administered European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) with supplemental esophageal cancer-specific questionnaires (OES-18) was queried after institutional review board approval through Creighton University School of Medicine. Inclusions were made if patients received an esophageal resection for benign or malignant esophageal disease. Emergency procedures, delayed reconstructions, and stage IV disease were excluded. Student’s t-test was used for domains of function, symptoms, QoL, and esophageal-specific complaints to compare the groups with each other and with the general population.ResultsA total of 39 out of 248 patients with malignant disease and 24 out of 46 with benign disease completed the questionnaire. A mean post-operative follow-up of 53 months with a response rate of 40% was obtained. There was no difference in physical (p=0.81), role (p =0.37), conditional (p=0.73), emotional (p=0.06), or social functions (p=0.42) between the general population and the esophageal resection groups. There was also no significant difference in generalized pain (p=0.86), nausea/vomiting (p=0.27), fatigue (p=0.86), swallowing (p=0.35), or esophageal pain (p=0.12). The malignant cohort had better outcomes than the benign cohort with respect to eating (p=0.04), indigestion (p=0.04), and QoL (p=<0.01).DiscussionThe underlying disease between these cohorts is drastically different, but postoperative functional status, generalized symptoms, swallowing ability, and esophageal pain were similar. There was no difference in functional status between the general population and the esophageal resection cohorts. Patients with malignant disease reported less problems with eating and a better QoL than their benign counterparts.

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“…In contrast to randomized trials, population-based and retrospective studies have shown the survival benefit of adding surgery [ 24 - 28 ]. Yen et al [ 29 ] showed that adding surgery was beneficial for survival using Taiwan tumor registry data.…”

Section: Surgery: Should It Be Performed After Neoadjuvant Therapy?mentioning

confidence: 99%

“…Yen et al [ 29 ] showed that adding surgery was beneficial for survival using Taiwan tumor registry data. Shao et al [ 28 ] evaluated the records of 8064 patients from the National Cancer Database and showed that tri-modal treatment was associated with better survival outcomes than definitive CRT in a matched analysis. Nomura et al [ 27 ] also showed that the surgery group had better survival outcomes based on a propensity score analysis.…”

Section: Surgery: Should It Be Performed After Neoadjuvant Therapy?mentioning

confidence: 99%

The Current Evidence on Neoadjuvant Therapy for Locally Advanced Esophageal Squamous Cell Carcinoma

Kim

2020

Korean J Thorac Cardiovasc Surg

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Surgical resection is the mainstay of treatment for locally advanced esophageal cancer. Neoadjuvant therapy is recommended to improve survival, based on the results of several randomized trials and meta-analyses. However, controversy remains regarding how to combine surgery, radiotherapy, and chemotherapy. Moreover, in East Asia, the predominant histological type is esophageal squamous cell carcinoma, which has a different epidemiology and tumor biology from esophageal or gastroesophageal junctional adenocarcinoma. As such, the management of esophageal cancer in East Asia seems to be different from that in Western countries. Thus, this article reviews the current evidence on neoadjuvant therapy and considers the optimal combinations and ongoing strategies of multimodal therapy for esophageal squamous cell carcinoma.

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Definitive or Preoperative Chemoradiation Therapy for Esophageal Cancer: Patterns of Care and Survival Outcomes

Cited by 26 publications

References 13 publications

Combined tumor plus nontumor interim FDG‐PET parameters are prognostic for response to chemoradiation in squamous cell esophageal cancer

Combined tumor plus nontumor interim FDG‐PET parameters are prognostic for response to chemoradiation in squamous cell esophageal cancer

Quality of life after esophageal resection

The Current Evidence on Neoadjuvant Therapy for Locally Advanced Esophageal Squamous Cell Carcinoma

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