Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis
<b>Background:</b>After the results reported by the “Chemoradiotherapy for esophageal Cancer Followed by Surgery Study” (CROSS) trial, neo-adjuvant chemoradiotherapy became the standard treatment for locally advanced cancers of esophagus and gastroesophageal junction (GEJ). Excellent res...
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MDPI AG
2021-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/4/666 |
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| author | Stefano de Pascale Paolo Parise Michele Valmasoni Jacopo Weindelmayer Fabrizia Terraneo Chiara Alessandra Cella Simone Giacopuzzi Andrea Cossu Simonetta Massaron Ugo Elmore Stefano Merigliano Uberto Fumagalli Romario on behalf of the Italian Society for the Study of Esophageal Diseases (SISME) |
| author_facet | Stefano de Pascale Paolo Parise Michele Valmasoni Jacopo Weindelmayer Fabrizia Terraneo Chiara Alessandra Cella Simone Giacopuzzi Andrea Cossu Simonetta Massaron Ugo Elmore Stefano Merigliano Uberto Fumagalli Romario on behalf of the Italian Society for the Study of Esophageal Diseases (SISME) |
| author_sort | Stefano de Pascale |
| collection | DOAJ |
| description | <b>Background:</b>After the results reported by the “Chemoradiotherapy for esophageal Cancer Followed by Surgery Study” (CROSS) trial, neo-adjuvant chemoradiotherapy became the standard treatment for locally advanced cancers of esophagus and gastroesophageal junction (GEJ). Excellent results were reported for squamocellular carcinomas (SCCs). Since the advent of the CROSS regimen, the results of surgery for esophageal adenocarcinomas (EAC) have cast some doubts about its efficacy on overall survival (OS) even in the presence of local response. This study evaluated the relation between pathological (yp) stage after CROSS regimen followed by surgery for adenocarcinoma of cardia and overall (OS) and disease-free survival (DFS). Sites of relapse after surgery were also analyzed. <b>Methods:</b> Patients submitted to the CROSS regimen for locally advanced EAC of the cardia followed by transthoracic esophagectomy were analyzed. Actuarial OS and DFS were analyzed and stratified according to yp stage. The site of relapse, distal and local, was also analyzed. <b>Results:</b> The study included 132 patients. The 50-month OS and DFS were 45% and 6.7%, respectively. No differences emerged analyzing OS according to yp stage. Time to relapse was significantly longer for yp Stage I and II, and for yp N0, compared with yp N+. Recurrence occurred in 48 cases (36.3%) with a 9 months median time to relapse. Local and distal relapse were 10 (7.5%) and 38 (28.7%) cases, respectively (<i>p</i> ≦ 0.001). <b>Conclusions:</b> Pathological stage after CROSS regimen does not relate to OS and DFS. Time to recurrence is significantly longer for yp Stages I and II and ypN0. Chemoradiotherapy in a neoadjuvant setting may influence the site of relapse, significantly reducing local recurrences. |
| first_indexed | 2024-03-09T05:16:16Z |
| format | Article |
| id | doaj.art-b71a7d098bf34ade8d781fdd9a6b06c7 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T05:16:16Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b71a7d098bf34ade8d781fdd9a6b06c72023-12-03T12:45:20ZengMDPI AGCancers2072-66942021-02-0113466610.3390/cancers13040666Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective AnalysisStefano de Pascale0Paolo Parise1Michele Valmasoni2Jacopo Weindelmayer3Fabrizia Terraneo4Chiara Alessandra Cella5Simone Giacopuzzi6Andrea Cossu7Simonetta Massaron8Ugo Elmore9Stefano Merigliano10Uberto Fumagalli Romario11on behalf of the Italian Society for the Study of Esophageal Diseases (SISME)Department of Surgery, European Institute of Oncology IRCCS, 20141 Milan, ItalyDepartment of Gastrointestinal Surgery, San Raffaele Scientific Institute, 20132 Milan, ItalyDepartment of Surgical, Oncological and Gastrointestinal Sciences, University of Padova, Clinica Chirurgica 3, 35128 Padova, ItalyGeneral and Upper GI Surgery Division, University of Verona, 37129 Verona, ItalyDepartment of Radiotherapy, Spedali Civili di Brescia, 25123 Brescia, ItalyGastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), 20143 Milan, ItalyGeneral and Upper GI Surgery Division, University of Verona, 37129 Verona, ItalyDepartment of Gastrointestinal Surgery, San Raffaele Scientific Institute, 20132 Milan, ItalyDepartment of Gastrointestinal Surgery, San Raffaele Scientific Institute, 20132 Milan, ItalyDepartment of Gastrointestinal Surgery, San Raffaele Scientific Institute, 20132 Milan, ItalyDepartment of Surgical, Oncological and Gastrointestinal Sciences, University of Padova, Clinica Chirurgica 3, 35128 Padova, ItalyDepartment of Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy<b>Background:</b>After the results reported by the “Chemoradiotherapy for esophageal Cancer Followed by Surgery Study” (CROSS) trial, neo-adjuvant chemoradiotherapy became the standard treatment for locally advanced cancers of esophagus and gastroesophageal junction (GEJ). Excellent results were reported for squamocellular carcinomas (SCCs). Since the advent of the CROSS regimen, the results of surgery for esophageal adenocarcinomas (EAC) have cast some doubts about its efficacy on overall survival (OS) even in the presence of local response. This study evaluated the relation between pathological (yp) stage after CROSS regimen followed by surgery for adenocarcinoma of cardia and overall (OS) and disease-free survival (DFS). Sites of relapse after surgery were also analyzed. <b>Methods:</b> Patients submitted to the CROSS regimen for locally advanced EAC of the cardia followed by transthoracic esophagectomy were analyzed. Actuarial OS and DFS were analyzed and stratified according to yp stage. The site of relapse, distal and local, was also analyzed. <b>Results:</b> The study included 132 patients. The 50-month OS and DFS were 45% and 6.7%, respectively. No differences emerged analyzing OS according to yp stage. Time to relapse was significantly longer for yp Stage I and II, and for yp N0, compared with yp N+. Recurrence occurred in 48 cases (36.3%) with a 9 months median time to relapse. Local and distal relapse were 10 (7.5%) and 38 (28.7%) cases, respectively (<i>p</i> ≦ 0.001). <b>Conclusions:</b> Pathological stage after CROSS regimen does not relate to OS and DFS. Time to recurrence is significantly longer for yp Stages I and II and ypN0. Chemoradiotherapy in a neoadjuvant setting may influence the site of relapse, significantly reducing local recurrences.https://www.mdpi.com/2072-6694/13/4/666gastroesophageal cancerCROSS regimenesophagogastric junction cancersneoadjuvant therapy |
| spellingShingle | Stefano de Pascale Paolo Parise Michele Valmasoni Jacopo Weindelmayer Fabrizia Terraneo Chiara Alessandra Cella Simone Giacopuzzi Andrea Cossu Simonetta Massaron Ugo Elmore Stefano Merigliano Uberto Fumagalli Romario on behalf of the Italian Society for the Study of Esophageal Diseases (SISME) Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis Cancers gastroesophageal cancer CROSS regimen esophagogastric junction cancers neoadjuvant therapy |
| title | Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis |
| title_full | Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis |
| title_fullStr | Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis |
| title_full_unstemmed | Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis |
| title_short | Does Pathological Stage and Nodal Involvement Influence Long Term Oncological Outcomes after CROSS Regimen for Adenocarcinoma of the Esophagogastric Junction? A Multicenter Retrospective Analysis |
| title_sort | does pathological stage and nodal involvement influence long term oncological outcomes after cross regimen for adenocarcinoma of the esophagogastric junction a multicenter retrospective analysis |
| topic | gastroesophageal cancer CROSS regimen esophagogastric junction cancers neoadjuvant therapy |
| url | https://www.mdpi.com/2072-6694/13/4/666 |
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