Impact of Neoadjuvant Chemoradiotherapy on Postoperative Outcomes After Esophageal Cancer Resection

Gronnier, Caroline; Tréchot, B.; Duhamel, Alain; Mabrut, Jean‐Yves; Bail, Jean‐Pierre; Carrère, Nicolas; Lefèvre, Jérémie H.; Brigand, Cécile; Vaillant, Jean‐Christophe; Adham, Mustapha; Msika, Simon; Demartines, Nicolas; Nakadi, Issam El; Piessen, Guillaume; Meunier, Brigitte; Collet, Denis; Mariette, C.

doi:10.1097/sla.0000000000000955

Cited by 85 publications

(64 citation statements)

References 31 publications

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“…Induction therapy may decrease FEV 1 % and D LCO %, thereby increasing the risk of postoperative PCs. However, a recent study [23] did not find an increased rate of PCs in patients who received neoadjuvant chemoradiotherapy compared with those who did not receive neoadjuvant chemoradiotherapy. Therefore, exclusion of patients who received induction may not influence the result of this study.…”

Section: Discussionmentioning

confidence: 94%

Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy

Xing¹,

Gao²,

Wang³

et al. 2016

World Journal of Emergency Medicine

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BACKGROUND: Esophagectomy is a very important method for the treatment of resectable esophageal cancer, which carries a high rate of morbidity and mortality. This study was undertaken to assess the predictive score proposed by Ferguson et al for pulmonary complications after esophagectomy for patients with cancer. METHODS:The data of patients who admitted to the intensive care unit after transthoracic esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College between September 2008 and October 2010 were retrospectively reviewed. RESULTS:Two hundred and seventeen patients were analyzed and 129 (59.4%) of them had postoperative pulmonary complications. Risk scores varied from 0 to 12 in all patients. The risk scores of patients with postoperative pulmonary complications were higher than those of patients without postoperative pulmonary complications (7.27±2.50 vs. 6.82±2.67; P=0.203). There was no significant difference in the incidence of postoperative pulmonary complications as well as in the increase of risk scores (χ 2 =5.477, P=0.242). The area under the curve of predictive score was 0.539±0.040 (95%CI 0.461 to 0.618; P=0.324) in predicting the risk of pulmonary complications in patients after esophagectomy. CONCLUSION:In this study, the predictive power of the risk score proposed by Ferguson et al was poor in discriminating whether there were postoperative pulmonary complications after esophagectomy for cancer patients.

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Section: Discussionmentioning

confidence: 94%

Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy

Xing¹,

Gao²,

Wang³

et al. 2016

World Journal of Emergency Medicine

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“…What was notable was that all of the six patients with leakage had undergone NCRT and cervical anastomosis. Some studies suggested that NCRT was a risk factor for morbidities and mortalities (19,20), while some others hold the opposed idea (21)(22)(23). A retrospective study from our center reported that cervical leakage occurred more frequently than intrathoracic leakage (23.6%, 145/615 vs. 5.0%, 101/2,023, P<0.001) (24).…”

Section: Discussionmentioning

confidence: 99%

Results of neoadjuvant therapy followed by esophagectomy for patients with locally advanced thoracic esophageal squamous cell carcinoma

Lin

et al. 2017

J. Thorac. Dis.

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Background: For patients diagnosed with locally advanced esophageal cancer, neoadjuvant therapy followed by surgery is the most common approach. However, randomized trials resulted in inconsistent conclusions. We conducted this retrospective study to evaluate the influence of neoadjuvant therapy on postoperative events and the influence on disease-free survival (DFS) and overall survival (OS). Methods:We retrospectively reviewed all of the patients underwent surgery following neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma (ESCC) during January 1st, 2013 and December 31st, 2015 in Fudan University Shanghai Cancer Center (FUSCC). Prognostic factors for DFS and OS were identified by univariate and multivariate analyses.Results: A total of fifty patients were included. Regarding postoperative morbidities, pneumonia and leakage occurred in 9 (18.0%) and 6 (12.0%) patients, respectively. For the whole patients, the 1-, 2-, 3-year DFS and OS rates were 57.0%, 48.0%, 42.0% and 86.0%, 73.0%, 62.0%, respectively. Lung metastasis and mediastinal node involvement were the most common relapse patterns. Univariate and multivariate analyses confirmed ypTNM stage as an independent prognostic factor for both DFS and OS; while leakage was an independent prognostic factor for DFS. Conclusions: Neoadjuvant therapy did not increase postoperative morbidities but did achieve favorable survival. The ypTNM stage was an independent prognostic factor for both DFS and OS. Long-term survival needs further investigation.

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“…En considérant que la moitié des patients sera atteinte d'une rechute locale dans le volume traité et qu'un tiers d'une évolution métastatique, il nous semble que l'irradiation ganglionnaire prophylactique doit être mesurée, étant donné la faible fréquence des rechutes ganglionnaires isolées hors volume irradié. Il est intéressant de rappeler ici que, malgré le fait que les séries chirurgicales mettent en évi-dence un tiers d'atteintes ganglionnaires du haut médiastin ou cervicales lors de curages étendus, les rechutes ganglionnaires susclaviculaires après chirurgie sont jugées suffisamment rares pour que le curage cervical ne soit plus utilisé par la plupart des équipes chirurgicales [29,30]. En effet, étant donné le peu de rechutes ganglionnaires cervicales et la morbidité associée au curage cervical, celui-ci n'est plus recommandé.…”

Section: Approche Empiriqueunclassified

Des marges extensives sont-elles nécessaires pour la radiothérapie du cancer de l’œsophage ?

Peyraga

Capitain

Rousseau

et al. 2015

Cancer/Radiothérapie

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Impact of Neoadjuvant Chemoradiotherapy on Postoperative Outcomes After Esophageal Cancer Resection

Abstract: Neoadjuvant chemoradiotherapy does not have an impact on the AL rate after EC resection (NCT 01927016).

Cited by 85 publications

References 31 publications

Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy

Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy

Results of neoadjuvant therapy followed by esophagectomy for patients with locally advanced thoracic esophageal squamous cell carcinoma

Des marges extensives sont-elles nécessaires pour la radiothérapie du cancer de l’œsophage ?

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