1. Significant understaging is seen in clinically staged T2N0 esophageal cancer patients undergoing esophagectomy.
- Author
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Dolan JP, Kaur T, Diggs BS, Luna RA, Sheppard BC, Schipper PH, Tieu BH, Bakis G, Vaccaro GM, Holland JM, Gatter KM, Conroy MA, Thomas CA Jr, and Hunter JG
- Subjects
- Adult, Aged, Chemoradiotherapy, Adjuvant methods, Esophagoscopy methods, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Outcome and Process Assessment, Health Care, Positron-Emission Tomography methods, Preoperative Period, Survival Rate, Tomography, X-Ray Computed methods, United States epidemiology, Adenocarcinoma mortality, Adenocarcinoma pathology, Adenocarcinoma surgery, Esophageal Neoplasms mortality, Esophageal Neoplasms pathology, Esophageal Neoplasms surgery, Esophagectomy methods, Esophagectomy statistics & numerical data
- Abstract
This study aimed to determine the impact of preoperative staging on the treatment of clinical T2N0 (cT2N0) esophageal cancer patients undergoing esophagectomy. We reviewed a retrospective cohort of 27 patients treated at a single institution between 1999 and 2011. Clinical staging was performed with computed tomography, positron emission tomography, and endoscopic ultrasound. Patients were separated into two groups: neoadjuvant therapy followed by surgery (NEOSURG) and surgery alone (SURG). There were 11 patients (41%) in the NEOSURG group and 16 patients (59%) in the SURG group. In the NEOSURG group, three of 11 patients (27%) had a pathological complete response and eight (73%) were partial or nonresponders after neoadjuvant therapy. In the SURG group, nine of 16 patients (56%) were understaged, 6 (38%) were overstaged, and 1 (6%) was correctly staged. In the entire cohort, despite being clinically node negative, 14 of 27 patients (52%) had node-positive disease (5/11 [45%] in the NEOSURG group, and 9/16 [56%] in the SURG group). Overall survival rate was not statistically significant between the two groups (P = 0.96). Many cT2N0 patients are clinically understaged and show no preoperative evidence of node-positive disease. Consequently, neoadjuvant therapy may have a beneficial role in treatment., (© 2015 International Society for Diseases of the Esophagus.)
- Published
- 2016
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