Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer
de Vos-Geelen, J.; Geurts, S. M.E.; Nieuwenhuijzen, G. A.P.; Voncken, F. E.M.; Bogers, J. A.; Braam, P. M.; Muijs, C. T.; de Jong, M. A.; Kasperts, N.; Rozema, T.; Blom, G. J.; Bouwense, S. A.W.; Valkenburg-van Iersel, L. B.J.; Jeene, P. M.; Hoebers, F. J.P.; Tjan-Heijnen, V. C.G.
(2021) European Journal of Surgical Oncology, volume 47, issue 8, pp. 2016 - 2022
(Article)
Abstract
Introduction: The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer. Materials and methods: Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in
... read more
11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses. Results: In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8–61.5 months), 58% (95% CI 48–66), and 49% (95% CI 40–57), respectively. Three- and five-year risk of recurrence were respectively 40% (95% CI 31–48), and 45% (95% CI 36–54). Three- and five-year risk of LRR were 26% (95% CI 19–33), and 30% (95% CI 22–38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached). Conclusion: In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years.
show less
Download/Full Text
Keywords: Cervical, Chemoradiotherapy, Esophagus, Relapse, Squamous cell cancer, Upper thoracic, Humans, Middle Aged, Antineoplastic Agents/therapeutic use, Salvage Therapy, Male, Netherlands, Time Factors, Aged, 80 and over, Adult, Female, Retrospective Studies, Cisplatin/therapeutic use, Kaplan-Meier Estimate, Neoplasm Recurrence, Local/epidemiology, Esophagectomy, Radiotherapy, Esophageal Squamous Cell Carcinoma/pathology, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Chemoradiotherapy/methods, Disease-Free Survival, Esophageal Neoplasms/pathology, Paclitaxel/administration & dosage, Progression-Free Survival, Carboplatin/administration & dosage, Aged, Oncology, Surgery, Journal Article
ISSN: 0748-7983
Publisher: W.B. Saunders Ltd
Note: Funding Information: JV has served as a consultant for AstraZeneca, MSD, Pierre Fabre, and Servier, and has received institutional research funding from Servier. All outside the submitted work. Funding Information: SG has received institutional research funding from Roche, Pfizer, Novartis, and Eli Lilly. All outside the submitted work. Funding Information: VT has received honoraria/travel grants from Roche, Novartis, Pfizer, Lilly, and Accord Healthcare, and has received institutional research funding from AstraZeneca, Roche, Pfizer, Novartis, Eisai, and Lilly. All outside the submitted work. Publisher Copyright: © 2021 The Authors Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
(Peer reviewed)