Prospective cohort comparison of neoadjuvant chemoradiotherapy <i>versus</i> chemotherapy in patients with oesophageal cancer

Morgan, Matthew A.; Lewis, Wyn G.; Crosby, Tom; Escofet, Xavier; Roberts, S. A.; Brewster, Alison; Harvard, Tim; Clark, Geoffrey W.B.

doi:10.1002/bjs.5671

Cited by 31 publications

(21 citation statements)

References 15 publications

(11 reference statements)

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“…All treatment was provided by an MDT experienced in the management of oesophageal cancer, whose results have been well audited (Morgan et al , 2007). The EUS component of this study represents particularly original work, and constitutes the only report comparing EUS factors with CRM status, relating this to the effects of neoadjuvant treatment.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of circumferential resection margin involvement following oesophagectomy for cancer and the predictive role of endoluminal ultrasonography

et al. 2012

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Background:The optimum multimodal treatment for oesophageal cancer, and the prognostic significance of histopathological tumour involvement of the circumferential resection margin (CRM+) are uncertain. The aims of this study were to determine the prognostic significance of CRM+ after oesophagectomy and to identify endosonographic (endoluminal ultrasonography (EUS)) features that predict a threatened CRM+.Methods:Two hundred and sixty-nine consecutive patients underwent potentially curative oesophagectomy (103 surgery alone, 124 neoadjuvant chemotherapy (CS) and 42 chemoradiotherapy (CRTS)). Primary outcome measures were disease-free survival (DFS) and overall survival (OS).Results:CRM+ was reported in 98 (38.0%) of all, and in 90 (62.5%) of pT3 patients. Multivariate analysis of pathological factors revealed: lymphovascular invasion (HR 2.087, 95% CI 1.396–3.122, P<0.0001), CRM+ (HR 1.762, 95% CI 1.201–2.586, P=0.004) and lymph node metastasis count (HR 1.563, 95% CI 1.018–2.400, P=0.041) to be independently and significantly associated with DFS. Lymphovascular invasion (HR 2.160, 95% CI 1.432–3.259, P<0.001) and CRM+ (HR 1.514, 95% CI 1.000–2.292, P=0.050) were also independently and significantly associated with OS. Multivariate analysis revealed EUS T stage (T3 or T4, OR 24.313, 95% CI 7.438–79.476, P<0.0001) and use or not of CRTS (OR 0.116, 95% CI 0.035–0.382, P<0.0001) were independently and significantly associated with CRM+.Conclusion:A positive CRM was a better predictor of DFS and OS than standard pTNM stage.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of circumferential resection margin involvement following oesophagectomy for cancer and the predictive role of endoluminal ultrasonography

et al. 2012

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“…Preoperative chemoradiation combined with surgery was recommended by the 2014 National Comprehensive Cancer Network guidelines for ESCC patients with local advanced stage. Several clinical trials have shown that a response to preoperative chemoradiation is crucial for the prognosis of patients after surgery: an obvious improvement to survival was observed in 25–30% of patients, with pathological complete response after surgery . Thus, to avoid ineffective treatment, finding biological markers that could predict the response to chemoradiation would benefit clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

RUNX3 reverses cisplatin resistance in esophageal squamous cell carcinoma via suppression of the protein kinase B pathway

Shi

Wang

2016

Thoracic Cancer

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BackgroundPreoperative chemoradiation combined with surgery has been of focus recently in order to improve prognosis in esophageal squamous cell carcinoma (ESCC) patients. Finding biological markers that may assist in predicting the therapeutic effect of chemoradiation may benefit the treatment effect. In this study, the role of RUNX3 in the formation of cisplatin resistance in ESCC was examined.MethodsThe study enrolled 103 stage IIa–IIIb ESCC patients who had undergone esophagectomy. RUNX3 expression in ESCC tissue was detected.ResultsA higher expression of RUNX3 in ESCC patients correlated with a more sensitive response to cisplatin‐based chemotherapy. A consistently lower expression of RUNX3 was found in the ESCC tissues of patients who agreed to perioperative chemotherapy compared with patients who had undergone no preoperative treatment. A lower RUNX3 expression in cisplatin‐resistant ESCC cell lines, Eca109 and TE‐1, was observed compared with parental cell lines. Heterologous RUNX3 expression significantly suppressed cisplatin resistance in Eca109 and TE‐1, both in vitro and vivo. Meanwhile, heterologous RUNX3 expression could inhibit growth and induce apoptosis in cisplatin resistant Eca109 and TE‐1 cell lines in vitro. Remarkable inhibition of the Akt pathway was observed in heterologous RUNX3 expression in Eca109 and TE‐1. Silencing Akt1 could reverse cisplatin resistance in Eca109 and TE‐1.ConclusionOur results confirmed that a loss of RUNX3 in ESCC may contribute to cisplatin‐resistance. RUNX3 could reverse cisplatin resistance via suppression of the Akt pathway in ESCC patients.

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“…As with many practical procedures there is a learning curve associated with performing EUS and the results reported in this study may not be applicable to centres with low case loads. The relatively low numbers of patients with EDFE reflects the relatively low prevalence of this finding in one of the largest prospective cohorts of oesophageal cancer patients reported from the UK [10,[19][20][21]. The very low number of patients with EUS-detected ascites implies that CT was effective in detecting this in the majority of patients.…”

Section: Discussionmentioning

confidence: 79%

Prognostic significance of endoscopic ultrasound-defined pleural, pericardial or peritoneal fluid in oesophageal cancer

et al. 2009

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Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer

Abstract: Neoadjuvant chemoradiotherapy should remain an option for patients with satisfactory performance status.

Cited by 31 publications

References 15 publications

Prognostic significance of circumferential resection margin involvement following oesophagectomy for cancer and the predictive role of endoluminal ultrasonography

Prognostic significance of circumferential resection margin involvement following oesophagectomy for cancer and the predictive role of endoluminal ultrasonography

RUNX3 reverses cisplatin resistance in esophageal squamous cell carcinoma via suppression of the protein kinase B pathway

Prognostic significance of endoscopic ultrasound-defined pleural, pericardial or peritoneal fluid in oesophageal cancer

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