Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial

Shapiro, Joël; Lanschot, J. Jan B. van; Hulshof, Maarten C.C.M.; Hagen, Pieter van; Henegouwen, Mark I. van Berge; Wijnhoven, Bas P. L.; Laarhoven, Hanneke W. M. van; Nieuwenhuijzen, Grard A. P.; Hospers, Geke A.P.; Bonenkamp, Johannes J.; Cuesta, Miguel A.; Blaisse, Reinoud J B; Busch, Olivier R.; Kate, Fiebo J.W. ten; Creemers, Geert-Jan; Punt, Cornelis J.A.; Plukker, John; Verheul, Henk M.W.; Bilgen, Ernst Jan Spillenaar; Dekken, Herman van; Sangen, M.J.C. van der; Rozema, Tom; Biermann, Katharina; Beukema, Jannet C.; Piet, Anna H.M.; Rij, Caroline M. van; Reinders, Janny G.; Tilanus, Hugo W.; Steyerberg, Ewout W.; Gaast, Ate van der

doi:10.1016/s1470-2045(15)00040-6

Cited by 2,096 publications

(1,838 citation statements)

References 20 publications

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“…In several datasets from Western countries that include different stages of the cancer, five-year overall survival after resection varies from 21 % to 47 % (18,19). In Norwegian datasets, five-year survival after curative resection has been between 8 % and 30 % (20 -23).…”

Section: Resultsmentioning

confidence: 99%

Reseksjon for oesophaguscancer – komplikasjoner og overlevelse

Grøtting¹,

Løberg²,

Johannessen³

et al. 2016

Tidsskriftet

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MAIN POINTSOutcomes for hybrid oesophageal section were no post-operative mortality, a low proportion of serious complications and good five-year survival There is a growing tendency for minimally invasive procedures in the surgical treatment of oesophageal cancer BACKGROUND Surgery is regarded as necessary for achieving a cure with oesophageal cancer. Minimally invasive procedures are increasingly being employed in oesophageal resection, with the aim of achieving fewer complications than with open surgery. The purpose of this study was to investigate post-operative complications, mortality and long-term survival after hybrid oesophageal resection by means of laparoscopy and thoracotomy.

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Section: Resultsmentioning

confidence: 99%

Reseksjon for oesophaguscancer – komplikasjoner og overlevelse

Grøtting¹,

Løberg²,

Johannessen³

et al. 2016

Tidsskriftet

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“…4,14 The median survival in each straight-to-surgery trial arm was approximately 13 months in the OE02 study and 24 months in the CROSS study, suggesting an improvement in survival related to improved perioperative care and selection over the time period between the two trials, although a small age difference may have also contributed to this. Changes in service provision in the UK have led to centralisation of services during this time, which could also account for the poor survival in the OE02 trial.…”

Section: Discussionmentioning

confidence: 99%

Postoperative survival following perioperative MAGIC versus neoadjuvant OE02-type chemotherapy in oesophageal adenocarcinoma

Saunders

et al. 2017

annals

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The optimal management of resectable oesophageal adenocarcinoma is controversial, with many centres using neoadjuvant chemotherapy following the Medical Research Council (MRC) oesophageal working group (OE02) trial and the MRC Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial. The more intensive MAGIC regimen is used primarily in gastric cancer but some also use it for oesophageal cancer. A database of cancer resections (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) provided information on survival of patients following either OE02 or MAGIC-type treatment. The data were compared using Kaplan-Meier analysis. Straight-to-surgery patients were also reviewed and divided into an 'early' cohort (2001( -2006 and a 'late ' cohort (2006' cohort ( -2013 to estimate changes in survival over time. Subgroup analysis was performed for responders (tumour regression grade [TRG] 1-3) versus non-responders (TRG 4 and 5) and for anatomical site (gastro-oesophageal junction [GOJ] vs oesophagus). An OE02 regimen was used for 97 patients and 275 received a MAGIC regimen. Those in the MAGIC group were of a similar age to those undergoing OE02 chemotherapy but the proportion of oesophageal cancers was higher among MAGIC patients than among those receiving OE02 treatment. MAGIC patients had a significantly lower stage following chemotherapy than OE02 patients and a higher median overall survival although TRG was similar. On subgroup analysis, this survival benefit was maintained for GOJ and oesophageal cancer patients as well as non-responders. Analysis of responders showed no difference between regimens. 'Late' group straight-to-surgery patients were significantly older than those in the 'early' group. Survival, however, was not significantly different for these two cohorts. Although the original MAGIC trial comprised few oesophageal cancer cases, our patients had better survival with MAGIC than with OE02 chemotherapy in all anatomical subgroups, even though there was no significant change in operative survival over the time period in which these patients were treated. The use of the MAGIC regimen should therefore be encouraged in cases of operable oesophagogastric adenocarcinoma.

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“…An impressive R0 resection rate of 92% after neoadjuvant CRT (compared to 69% after surgery) was reported; 29% of patients who underwent resection after neoadjuvant CRT showed a pathologic complete response (pCR), this rate was 23% when only adenocarcinoma patients were considered. Follow-up data showed that CRT significantly reduced both locoregional and distant recurrences compared to surgery alone [20]. While both univariate and multivariate analyses indicated a significant overall survival benefit of neoadjuvant CRT in SCC, the median overall survival improved with multimodal treatment in esophageal and EGJ adenocarcinoma: 43.2 months compared to 27.1 months after surgery alone.…”

Section: Neoadjuvant Therapy: Chemotherapy Versus Chemoradiotherapymentioning

confidence: 97%

Western strategy for EGJ carcinoma

et al. 2016

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In this paper, the epidemiological and clinicobiological behavior of esophagogastric junction (EGJ) adenocarcinoma in the West is compared and contrasted to that in the East, and an overview is provided of current therapeutic strategies employed for this type of tumor in Western countries. It is well known that multimodal treatment is the therapeutic standard in locally advanced EGJ adenocarcinoma, but whether neoadjuvant/perioperative chemotherapy (CT) or neoadjuvant chemoradiotherapy (CRT) is the optimal approach is still debated. Neoadjuvant CRT improves local control in locally advanced Siewert type I and II tumors, so it should be considered the treatment of choice. In the subset of these patients with microscopic systemic disease at diagnosis, more intensive exclusive chemotherapy protocols could be of benefit. Therefore, there is an urgent need to identify these patients before planning the treatment. For Siewert type III tumors, perioperative chemotherapy is the standard. While there is general agreement on the optimal surgical approach for Siewert types I and III (a two-field Ivor Lewis operation and a total gastrectomy with distal esophagectomy, respectively), no standard surgical treatment has been defined for Siewert type II tumors. When data from Western series on proximal and circumferential resection margins and on nodal spread in Siewert type II tumors are taken into account, the optimal surgical approach appears to be Ivor Lewis esophagectomy. Whether the extent of esophageal invasion can correctly predict nodal involvement in middle-upper mediastinal stations as a means to restrict indications for transthoracic esophagectomy requires further investigation in the West.

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Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial

Cited by 2,096 publications

References 20 publications

Reseksjon for oesophaguscancer – komplikasjoner og overlevelse

Reseksjon for oesophaguscancer – komplikasjoner og overlevelse

Postoperative survival following perioperative MAGIC versus neoadjuvant OE02-type chemotherapy in oesophageal adenocarcinoma

Western strategy for EGJ carcinoma

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