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
TLDR
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.Abstract:
Summary Background In a previous meta-analysis, we identified a survival benefit from neoadjuvant chemotherapy or chemoradiotherapy before surgery in patients with resectable oesophageal carcinoma. We updated this meta-analysis with results from new or updated randomised trials presented in the past 3 years. We also compared the benefits of preoperative neoadjuvant chemotherapy compared with neoadjuvant chemoradiotherapy. Methods To identify additional studies and published abstracts from major scientific meetings, we searched Medline, Embase, and Central (Cochrane clinical trials database) for studies published since January, 2006, and also manually searched for abstracts from major conferences from the same period. Only randomised studies analysed by intention to treat were included, and searches were restricted to those databases citing articles in English. We used published hazard ratios (HRs) if available or estimates from other survival data. We also investigated treatment effects by tumour histology and relations between risk (survival after surgery alone) and effect size. Findings We included all 17 trials from the previous meta-analysis and seven further studies. 12 were randomised comparisons of neoadjuvant chemoradiotherapy versus surgery alone (n=1854), nine were randomised comparisons of neoadjuvant chemotherapy versus surgery alone (n=1981), and two compared neoadjuvant chemoradiotherapy with neoadjuvant chemotherapy (n=194) in patients with resectable oesophageal carcinoma; one factorial trial included two comparisons and was included in analyses of both neoadjuvant chemoradiotherapy (n=78) and neoadjuvant chemotherapy (n=81). The updated analysis contained 4188 patients whereas the previous publication included 2933 patients. This updated meta-analysis contains about 3500 events compared with about 2230 in the previous meta-analysis (estimated 57% increase). The HR for all-cause mortality for neoadjuvant chemoradiotherapy was 0·78 (95% CI 0·70–0·88; p Interpretation This updated meta-analysis provides strong evidence for a survival benefit of neoadjuvant chemoradiotherapy or chemotherapy over surgery alone in patients with oesophageal carcinoma. A clear advantage of neoadjuvant chemoradiotherapy over neoadjuvant chemotherapy has not been established. These results should help inform decisions about patient management and design of future trials. Funding Cancer Australia and the NSW Cancer Institute.read more
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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
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
TL;DR: Long-term follow-up confirms the overall survival benefits for neoadjuvant chemoradiotherapy in patients with clinically resectable, locally advanced cancer of the oesophagus or Oesophagogastric junction and shows a significant increase in 5-year overall survival.
Journal ArticleDOI
Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial.
Surya S. A. Y. Biere,Mark I. van Berge Henegouwen,K. W. Maas,Luigi Bonavina,Camiel Rosman,Josep Garcia,Suzanne S. Gisbertz,Jean H. G. Klinkenbijl,Markus W. Hollmann,Elly S. M. de Lange,H. Jaap Bonjer,Donald L. van der Peet,Miguel A. Cuesta +12 more
TL;DR: Findings provide evidence for the short-term benefits of minimally invasive oesophagectomy for patients with resectable Oesophageal cancer.
Journal ArticleDOI
Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
TL;DR: In the EU, the highest age-standardised incidence rates for oesophageal cancer are in the Netherlands for men and the UK for women, and variation between countries is high and may reflect different prevalence of risk factors, use of screening and diagnostic methods.
Journal ArticleDOI
Marital Status and Survival in Patients With Cancer
Ayal A. Aizer,Ming-Hui Chen,Ellen P. McCarthy,Mallika L. Mendu,Sophia Koo,Tyler J. Wilhite,Powell L. Graham,Toni K. Choueiri,Karen E. Hoffman,Neil E. Martin,Jim C. Hu,Paul L. Nguyen +11 more
TL;DR: Even after adjusting for known confounders, unmarried patients are at significantly higher risk of presentation with metastatic cancer, undertreatment, and death resulting from their cancer.
Journal ArticleDOI
Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology.
Jaffer A. Ajani,Thomas A. D'Amico,David J. Bentrem,Joseph Chao,Carlos U. Corvera,Prajnan Das,Crystal S. Denlinger,Peter C. Enzinger,Paul T. Fanta,Farhood Farjah,Hans Gerdes,Michael Gibson,Robert E. Glasgow,James A. Hayman,Steven N. Hochwald,Wayne L. Hofstetter,David H. Ilson,Dawn E. Jaroszewski,Kimberly L. Johung,Rajesh N. Keswani,Lawrence Kleinberg,Stephen Leong,Quan P. Ly,Kristina A. Matkowskyj,Michael McNamara,Mary F. Mulcahy,Ravi Kumar Paluri,Haeseong Park,Kyle A. Perry,Jose M. Pimiento,George A. Poultsides,Robert E. Roses,Vivian E. Strong,Georgia L. Wiesner,Christopher G. Willett,Cameron D. Wright,Nicole R. McMillian,Lenora A. Pluchino +37 more
TL;DR: This selection from the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers focuses on recommendations for the management of locally advanced and metastatic adenocarcinoma of the esophagus and EGJ.
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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
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