Time interval between neoadjuvant chemoradiotherapy and surgery for oesophageal or junctional cancer: A nationwide study

Werf, Leonie R. van der; Dikken, Johan L.; Willik, Esmee M van der; Henegouwen, Mark I. van Berge; Nieuwenhuijzen, Grard A. P.; Wijnhoven, Bas P. L.; Bosscha, K.; Grieken, Nicole C.T. van; Hartgrink, H.H.; Hillegersberg, Richard van; Lemmens, V.E.P.P.; Plukker, John Theodorus; Rosman, Camiel; Sandick, J. W. van; Siersema, Peter D.; Tetteroo, G. W. M.; Veldhuis, P.; Voncken, Francine E.M.

doi:10.1016/j.ejca.2017.12.009

Cited by 40 publications

(30 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From previous studies with DUCA data, it is known that higher age, ASA score, body mass index, Nþ status, proximal-mid esophageal tumorlocation, and open transthoracic procedures are associated with an increased risk for postoperative complications. 8,9 Some of these factors were more frequently present in the DUCA, for example, 30% of patients were older than 70 years old (vs 23% in the ECCG cohort). However, in the ECCG cohort, patients with ASA III or higher were more frequently present then in the DUCA (39% vs 21%).…”

Section: Discussionmentioning

confidence: 99%

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

et al. 2019

View full text Add to dashboard Cite

Objective: This nationwide population-based study aimed to report postoperative morbidity and mortality after esophagectomy and gastrectomy in the Netherlands according to the definitions of the Esophagectomy Complications Consensus Group (ECCG). Background: To standardize international outcome reporting in esophageal surgery, the ECCG developed a standardized outcomes set. Methods: For this national cohort study, all patients undergoing esophagectomy or gastrectomy for cancer between 2016 and 2017 were selected from the Dutch Upper gastrointestinal Cancer Audit. In a random sample of hospitals, data completeness and accuracy were validated by reabstraction of the data. The investigated outcomes in the present study were postoperative complications, major complications (Clavien-Dindo grade !III), and 30-day mortality, according to definitions of the ECCG. Results: A total of 2545 patients from 22 hospitals were included. The completeness of the Dutch Upper gastrointestinal Cancer Audit was estimated at 99.8%. Data accuracy on different items was 94% to 100%. After esophagectomy, 1046 of 1617 patients (65%) had a postoperative complication including 468 patients (29%) with a major complication. Most common complications were pneumonia (21%), esophago-enteric leak from anastomosis, staple line or localized conduit necrosis (19%), and atrial dysrhythmia (15%). The 30-day mortality was 1.7%. After gastrectomy, 397 of 928 patients (42%) had a postoperative complication including 180 patients (19%) with a major complication. Most common complications were pneumonia (12%), esophago-enteric leak from anastomosis, staple line or localized conduit necrosis (9%), and acute delirium (5%). The 30-day mortality was 4.4%. Conclusions: Reporting complications according to the ECCG platform is feasible in the Netherlands and facilitates international benchmarking.

show abstract

Section: Discussionmentioning

confidence: 99%

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

et al. 2019

View full text Add to dashboard Cite

show abstract

“…We screened 2308 eligible studies and identified 19 studies including two relevant articles from the same study by Franko et al[ 13 , 14 ] and two studies[ 15 , 16 ] without sufficient data to calculate HR and 95%CI. Sixteen studies were finally selected for the meta-analysis to determine whether the time interval from completion of nCRT to surgery has an effect on survival outcome[ 5 , 7 - 11 , 14 , 17 - 25 ].…”

Section: Resultsmentioning

confidence: 99%

Timing of surgery after neoadjuvant chemoradiotherapy affects oncologic outcomes in patients with esophageal cancer

Shang¹,

Yang²,

Gu³

et al. 2020

WJGO

View full text Add to dashboard Cite

BACKGROUND The optimal time interval between neoadjuvant chemoradiotherapy (nCRT) and esophagectomy in esophageal cancer has not been defined. AIM To evaluate whether a prolonged time interval between the end of nCRT and surgery has an effect on survival outcome in esophageal cancer patients. METHODS We searched PubMed, Embase, Web of Science, the Cochrane Library, Wanfang and China National Knowledge Infrastructure databases for relevant articles published before November 16, 2019, to identify potential studies that evaluated the prognostic role of different time intervals between nCRT and surgery in esophageal cancer. The hazard ratios and 95% confidence intervals (95%CI) were merged to estimate the correlation between the time intervals and survival outcomes in esophageal cancer, esophageal squamous cell carcinoma and adenocarcinoma using fixed- and random-effect models. RESULTS This meta-analysis included 12621 patients from 16 studies. The results demonstrated that esophageal cancer patients with a prolonged time interval between the end of nCRT and surgery had significantly worse overall survival (OS) [hazard ratio (HR): 1.107, 95%CI: 1.014-1.208, P = 0.023] than those with a shorter time interval. Subgroup analysis showed that poor OS with a prolonged interval was observed based on both the sample size and HRs. There was also significant association between a prolonged time interval and decreased OS in Asian, but not Caucasian patients. In addition, a longer wait time indicated worse OS (HR: 1.385, 95%CI: 1.186-1.616, P < 0.001) in patients with adenocarcinoma. CONCLUSION A prolonged time interval from the completion of nCRT to surgery is associated with a significant decrease in OS. Thus, esophagectomy should be performed within 7-8 wk after nCRT.

show abstract

“…Due to, for example, logistic reasons this date varied. Variations in time between neoadjuvant therapy and surgery impact the observed pathologic response and could therefore influence our results [34,35].…”

Section: Discussionmentioning

confidence: 99%

DW-MRI and DCE-MRI are of complementary value in predicting pathologic response to neoadjuvant chemoradiotherapy for esophageal cancer

et al. 2018

View full text Add to dashboard Cite

show abstract

Time interval between neoadjuvant chemoradiotherapy and surgery for oesophageal or junctional cancer: A nationwide study

Cited by 40 publications

References 22 publications

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

Timing of surgery after neoadjuvant chemoradiotherapy affects oncologic outcomes in patients with esophageal cancer

DW-MRI and DCE-MRI are of complementary value in predicting pathologic response to neoadjuvant chemoradiotherapy for esophageal cancer

Contact Info

Product

Resources

About