Journal Article10.1200/JCO.2013.51.2186
Patterns of Recurrence After Surgery Alone Versus Preoperative Chemoradiotherapy and Surgery in the CROSS Trials
Vera Oppedijk,Ate van der Gaast,J. Jan B. van Lanschot,Pieter van Hagen,Rob M. van Os,Caroline M. van Rij,Maurice J.C. van der Sangen,Jannet C. Beukema,H.J.T. Rutten,Patty H. Spruit,Janny G. Reinders,Dick J. Richel,Mark I. van Berge Henegouwen,Maarten C.C.M. Hulshof +13 more
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TL;DR: Preoperative CRT in patients with esophageal cancer reduced locoregional recurrence and peritoneal carcinomatosis and there was a small but significant effect on hematogenous dissemination in favor of the CRT group.
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Abstract: Purpose To analyze recurrence patterns in patients with cancer of the esophagus or gastroesophageal junction treated with either preoperative chemoradiotherapy (CRT) plus surgery or surgery alone. Patients and Methods Recurrence pattern was analyzed in patients from the previously published CROSS I and II trials in relation to radiation target volumes. CRT consisted of five weekly courses of paclitaxel and carboplatin combined with a concurrent radiation dose of 41.4 Gy in 1.8-Gy fractions to the tumor and pathologic lymph nodes with margin. Results Of the 422 patients included from 2001 to 2008, 418 were available for analysis. Histology was mostly adenocarcinoma (75%). Of the 374 patients who underwent resection, 86% were allocated to surgery and 92% to CRT plus surgery. On January 1, 2011, after a minimum follow-up of 24 months (median, 45 months), the overall recurrence rate in the surgery arm was 58% versus 35% in the CRT plus surgery arm. Preoperative CRT reduced locoregional recurrence (LRR) from 3...
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The optimal neoadjuvant treatment of locally advanced esophageal cancer
Berend J van der Wilk,Ben M Eyck,Sjoerd M. Lagarde,Ate van der Gaast,Joost J. Nuyttens,Bas P. L. Wijnhoven,J. Jan B. van Lanschot +6 more
TL;DR: This review aims at providing an overview of the currently available neoadjuvant treatments in esophageal cancer, finding a benefit for chemoradiotherapy in the number of pathologically complete responders, radical resection rate and possibly even in overall survival.
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The Role of Radiotherapy in Localized Esophageal and Gastric Cancer
TL;DR: The evolving role of radiotherapy in the multidisciplinary management of esophageal, GEJ, and gastric cancer is reviewed, summarizing the results of recent clinical trials leading to contemporary accepted treatment approaches.
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Low- vs. High-Dose Neoadjuvant Radiation in Trimodality Treatment of Locally Advanced Esophageal Cancer.
Keven Seung Yong Ji,Samantha M. Thomas,Samantha M. Thomas,Sanziana A. Roman,Brian G. Czito,Kevin L. Anderson,Jessica Frakes,Mohamed A. Adam,Julie Ann Sosa,Timothy J. Robinson +9 more
TL;DR: Retrospective analysis of adults with non-metastatic esophageal cancer in the National Cancer Database (2004–2015) treated with neoadjuvant chemoradiotherapy supports the use of 41.4 Gy in patients with chemoradiation followed by esophagectomy, and indicates reduced perioperative mortality and superior overall survival with similar downstaging in locally advanced esophAGEal cancer.
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Multimodality Management of Esophageal Cancer
TL;DR: This review addresses various issues concerning multimodality management of locally advanced esophageal cancers: Does neoadjuvant therapy offer a definite benefit over surgery alone?
Distribution of lymph node metastases in esophageal adenocarcinoma after neoadjuvant chemoradiation therapy: a prospective study.
E R C Hagens,Hannah T. Künzli,Anne-Sophie van Rijswijk,Sybren L. Meijer,R. Clinton D. Mijnals,Bas L. Weusten,E. Debby Geijsen,Hanneke W. M. van Laarhoven,Mark I. van Berge Henegouwen,Suzanne S. Gisbertz +9 more
TL;DR: The distribution of lymph node metastases in esophageal adenocarcinoma following neoadjuvant chemoradiation (nCRTx) is unclear, but may have consequences for radiotherapy and surgery, and nCRTx is therefore not a reason to minimize lymphadenectomy in patients with esophagesis.
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