新辅助治疗改善cT3N0M0食管癌的预后

ANNALS OF SURGERY

2017-07-24Article

8.980

影响因子

原标题:临床分期T3N0M0食管癌新辅助治疗的生存获益:欧洲多中心研究的回顾性分析

① 30个欧洲中心,2944例食管癌患者中,382例(13.0%)首次诊断时为临床分期T3N0M0,193例手术(S),189例新辅助治疗联合手术(NS);② 两组间,pN+分别为64.2% 和42.9%,pN2/N3分别为35.2% 和21.2%,0期分别为0% 和16.4%,R0分别为81.3%和89.4%;③ 中位生存期分别为27.9个月和38.4个月,无进展生存期分别为27.5个月和31.6个月;④ 多变量分析,新辅助治疗是独立的预后因素,HR0.76;⑤ 新辅助治疗明显改善临床分期T3N0M0食管癌的生存。

食管癌 新辅助治疗 生存期

图片

Title:
Survival Benefit of Neoadjuvant Treatment in Clinical T3N0M0 Esophageal Cancer: Results From a Retrospective Multicenter European Study

DOI:
10.1097/SLA.0000000000002402

Abstract & Authors展开

Abstract:
Based on current guidelines, clinical T3N0M0 esophageal tumors may or may not receive neoadjuvant treatment, according to their perception as locally advanced (cT3) or early-stage tumors (stage II). The study aim was to assess the impact of neoadjuvant treatment upon survival for cT3N0M0 esophageal cancer patients, with subgroup analyses by histological type (squamous cell carcinoma vs adenocarcinoma) and type of neoadjuvant treatment (chemotherapy vs radiochemotherapy). Data from patients operated on for esophageal cancer in 30 European centers were collected. Among the 382 of 2944 patients with clinical T3N0M0 stage at initial diagnosis (13.0%), we compared those treated with primary surgery (S, n = 193) versus with neoadjuvant treatment plus surgery (NS, n = 189). The S and NS groups were similar regarding their demographic and surgical characteristics. In-hospital postoperative morbidity and mortality rates were comparable between groups. Patients were found to be pN+ in 64.2% versus 42.9% in the S and NS groups respectively (P < 0.001), pN2/N3 in 35.2% versus 21.2% (P < 0.001), stage 0 in 0% versus 16.4% (P < 0.001), and R0 in 81.3% versus 89.4% of cases (P = 0.026). Median overall and disease-free survivals were significantly better in the NS group, 38.4 versus 27.9 months (P = 0.007) and 31.6 versus 27.5 months (P = 0.040), respectively, and this difference remained for both histological types. Radiotherapy did not offer a benefit compared with chemotherapy alone (P = 0.687). In multivariable analysis, neoadjuvant treatment was an independent favorable prognostic factor (HR 0.76, 95% CI 0.58-0.99, P = 0.044). Neoadjuvant treatment offers a significant survival benefit for clinical T3N0M0 esophageal cancer.

All Authors:
Styliani Mantziari,Caroline Gronnier,Florence Renaud,Alain Duhamel,Jérémie Théreaux,Cécile Brigand,Nicolas Carrère,Jérémie H Lefevre,Arnaud Pasquer,Nicolas Demartines,Denis Collet,Bernard Meunier,Christophe Mariette,

First Authors:
Styliani Mantziari

Correspondence:
Styliani Mantziari

下载PDF原文

已完成

请稍等...

提示
提示