Journal ArticleDOI
Morbidity and mortality after surgery for cancer of the oesophagus and gastro-oesophageal junction: A randomized clinical trial of neoadjuvant chemotherapy vs. neoadjuvant chemoradiation.
Fredrik Klevebro,Gjermund Johnsen,Egil Johnson,Asgaut Viste,T. Myrnas,Eva Szabo,Anne-Birgitte Jacobsen,Signe Friesland,Jon A. Tsai,Saga Persson,Mats Lindblad,Lars Lundell,Magnus Nilsson +12 more
Reads0
Chats0
TLDR
There was no significant difference in the incidence of complications between patients randomized to nCT and n CRT, however, complications were significantly more severe after nCRT.Abstract:
Objective To compare the incidence and severity of postoperative complications after oesophagectomy for carcinoma of the oesophagus and gastro-oesophageal junction (GOJ) after randomized accrual to neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT). Background Neoadjuvant therapy improves long-term survival after oesophagectomy. To date, evidence is insufficient to determine whether combined nCT, or nCRT alone, is the most beneficial. Methods Patients with carcinoma of the oesophagus or GOJ, resectable with a curative intention, were enrolled in this multicenter trial conducted at seven centres in Sweden and Norway. Study participants were randomized to nCT or nCRT followed by surgery with two-field lymphadenectomy. Three cycles of cisplatin/5-fluorouracil was administered in all patients, while 40 Gy of concomitant radiotherapy was administered in the nCRT group. Results Of the randomized 181 patients, 91 were assigned to nCT and 90 to nCRT. One-hundred-and-fifty-five patients, 78 nCT and 77 nCRT, underwent resection. There was no statistically significant difference between the groups in the incidence of surgical or nonsurgical complications (P-value = 0.69 and 0.13, respectively). There was no 30-day mortality, while the 90-day mortality was 3% (2/78) in the nCT group and 6% (5/77) in the nCRT group (P = 0.24). The median Clavien-Dindo complication severity grade was significantly higher in the nCRT group (P = 0.001). Conclusion There was no significant difference in the incidence of complications between patients randomized to nCT and nCRT. However, complications were significantly more severe after nCRT. Registration trial database The trial was registered in the Clinical Trials Database (registration number NCT01362127 ).read more
Citations
More filters
Journal ArticleDOI
Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1.
Yuko Kitagawa,Takashi Uno,Tsuneo Oyama,Ken Kato,Hiroyuki Kato,Hirofumi Kawakubo,Osamu Kawamura,Motoyasu Kusano,Hiroyuki Kuwano,Hiroya Takeuchi,Yasushi Toh,Yuichiro Doki,Yoshio Naomoto,Kenji Nemoto,Eisuke Booka,Hisahiro Matsubara,Tatsuya Miyazaki,Manabu Muto,Akio Yanagisawa,Masahiro Yoshida +19 more
TL;DR: These guidelines are intended to allow physicians to undertake diagnosis and treatment of esophageal cancer by sharing the information contained in the guidelines and promote mutual understanding among the healthcare professionals, patients, and their family members.
Journal ArticleDOI
A randomized clinical trial of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the oesophagus or gastro-oesophageal junction
Fredrik Klevebro,G. Alexandersson von Döbeln,N. Wang,Gjermund Johnsen,Anne-Birgitte Jacobsen,Signe Friesland,Ingunn Hatlevoll,Nils Glenjen,Pehr Lind,Jon A. Tsai,Lars Lundell,Magnus Nilsson +11 more
TL;DR: The addition of radiotherapy to neoadjuvant chemotherapy results in higher histological complete response rate, higher R0 resection rate, and a lower frequency of lymph-node metastases, without significantly affecting survival.
Journal ArticleDOI
Cancer immunity and therapy using hyperthermia with immunotherapy, radiotherapy, chemotherapy, and surgery
TL;DR: The perceptions indicate that hyperthermia has potential for cancer therapy in conjunction with immunotherapy, chemotherapy, radiotherapy, and surgery, and the current understanding concerning cancer immunity and involvement ofhyperthermia and the innate and adoptive immune system is focused on.
Journal ArticleDOI
Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)
Leonie R. van der Werf,Linde A. D. Busweiler,Johanna W. van Sandick,Mark I. van Berge Henegouwen,Bas P. L. Wijnhoven +4 more
TL;DR: Reporting complications according to the ECCG platform is feasible in the Netherlands and facilitates international benchmarking.
Journal ArticleDOI
Morbidity and Mortality of Patients Who Underwent Minimally Invasive Esophagectomy After Neoadjuvant Chemoradiotherapy vs Neoadjuvant Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Randomized Clinical Trial
Hao Wang,Han Tang,Yong Fang,Lijie Tan,Jun Yin,Yaxing Shen,Zhao-Chong Zeng,Jiangyi Zhu,Yingyong Hou,Ming Du,Jia Jiao,Hongjing Jiang,Lei Gong,Zhigang Li,Jun Liu,Deyao Xie,Wenfeng Li,Changhong Lian,Qiang Zhao,Chun Chen,Bin Zheng,Yongde Liao,Kuo Li,Hecheng Li,Han Wu,Liang Dai,Ke-Neng Chen +26 more
TL;DR: This trial shows that the safety of nCRT followed by MIE is similar to that of nCT for the treatment of locally advanced ESCC.
References
More filters
Journal ArticleDOI
Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.
TL;DR: The new complication classification appears reliable and may represent a compelling tool for quality assessment in surgery in all parts of the world.
Journal ArticleDOI
Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer
TL;DR: Preoperative chemoradiotherapy improved survival among patients with potentially curable esophageal or esophagogastric-junction cancer and the regimen was associated with acceptable adverse-event rates.
Journal ArticleDOI
Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis
Katrin Marie Sjoquist,Bryan Burmeister,B. Mark Smithers,B. Mark Smithers,John Zalcberg,R. John Simes,Andrew Barbour,Andrew Barbour,Val Gebski +8 more
TL;DR: This updated meta-analysis provides strong evidence for a survival benefit of neoadjuvant chemoradiotherapy or chemotherapy over surgery alone in patients with oesophageal carcinoma and investigates treatment effects by tumour histology and relations between risk (survival after surgery alone) and effect size.
Journal Article
Proposed classification of complications of surgery with examples of utility in cholecystectomy.
TL;DR: Risk factors for development of complications were determined, and the classification was also used to analyze the value of a modified APACHE II as a preoperative prognostic score, which supported the relevance of the proposed classification.
Journal ArticleDOI
The comprehensive complication index: a novel continuous scale to measure surgical morbidity.
TL;DR: The CCI summarizes all postoperative complications and is more sensitive than existing morbidity endpoints and may serve as a standardized and widely applicable primary endpoint in surgical trials and other interventional fields of medicine.
Related Papers (5)
Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial
Joel Shapiro,J. Jan B. van Lanschot,Maarten C.C.M. Hulshof,Pieter van Hagen,Mark I. van Berge Henegouwen,Bas P. L. Wijnhoven,Hanneke W. M. van Laarhoven,Grard A. P. Nieuwenhuijzen,Geke A. P. Hospers,Johannes J. Bonenkamp,Miguel A. Cuesta,Reinoud J. B. Blaisse,Olivier R. Busch,Fiebo J. W. ten Kate,Geert-Jan Creemers,Cornelis J. A. Punt,John T. M. Plukker,Henk M.W. Verheul,Ernst Jan Spillenaar Bilgen,Herman van Dekken,Maurice J.C. van der Sangen,Tom Rozema,Katharina Biermann,Jannet C. Beukema,Anna H.M. Piet,Caroline M. van Rij,Janny G. Reinders,Hugo W. Tilanus,Ewout W. Steyerberg,Ate van der Gaast +29 more