Details

Autor(en) / Beteiligte

• Stefano, de Pascale
• Paolo, Parise
• Michele, Valmasoni
• Jacopo, Weindelmayer
• Fabrizia, Terraneo
• Chiara, Alessandra Cella
• Simone, Giacopuzzi
• Andrea, Cossu
• Stefano, Merigliano
• Uberto, Fumagalli Romario
• Riccardo, Rosati

Titel

P192 CROSS REGIMEN FOR ADENOCARCINOMA OF THE ESOPHAGUS AND CARDIA: DOES PATHOLOGICAL RESPONSE INFLUENCE OVERALL AND DISEASE FREE SURVIVAL? MULTICENTER RETROSPECTIVE ANALYSIS

Ist Teil von

• Diseases of the esophagus, 2019-11, Vol.32 (Supplement_2)

Ort / Verlag

Oxford University Press

Erscheinungsjahr

2019

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Aim Primary aim is to evaluate the relationship between pathological response after CROSS regimen for locally advanced esophageal adenocarcinomas and overall and disease-free survival. Secondary endpoint is to analyze the principal sites of relapse after surgery in this group of patients. Background & Methods The CROSS trial showed an improvement of overall survival after neoadjuvant chemoradiation and subsequent surgical resection compared to surgery alone for patients with esophageal cancer, representing the benchmark [1]. Patients submitted to CROSS regimen for adenocarcinoma of the esophagus and cardia followed by esophagectomy with a transthoracic extended lymphadenectomy were analyzed. The patients were treated in 4 centers part of Italian Group for the Study of Esophageal Diseases (SISME). Actuarial Overall survival (OS) and actuarial disease-free survival (DFS) were analyzed and stratified according to yp Stage (1 – stage I and II; 2 – stage IIIA and IIIB and 3 - stage IVA) as described in the 8th edition of TNM. Kaplan-Meier method was used to estimate overall and progression-free survival, with the log-rank test to ascertain significance (p<0.05). Median and range were used. Statistical analysis was done with SPSS version 21.0. Results 132 patients, from January 2014 to February 2019, were analyzed. Median age was 63 years (range 42-82). The site of the neoplasm was the distal esoghagus-EGJ in 127 cases and the middle esophagus in 5. Ivor Lewis was the procedure adopted. Fifty-month OS and DFS were respectively 42% and 6.7% respectively. No difference emerged when overall survival was analyzed according to yp Stages. Time to relapse is significantly longer for ypStage I and II. Recurrence occurred in 48 cases (36.3%) with 9 months as median time to relapse. Local and distal relapse were 10 (paratracheal nodes) and 38 respectively (7.5% and 28.7%, p<0.001). Conclusion Pathological response after CROSS regimen doesn’t relate to OS and DFS. Time to recurrence is significantly longer for yp Stage 1 e 2 rather than other ypStages. Chemoradiotherapy in a neoadjuvant setting may influence the site of relapse.