1. Multicentre study of neoadjuvant chemotherapy for stage I and II oesophageal cancer
- Author
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S Bekkar, C Gronnier, F Renaud, A Duhamel, A Pasquer, J Théreaux, J Gagnière, B Meunier, D Collet, C Mariette, A Dhahri, D Lignier, C Cossé, J-M Regimbeau, G Luc, M Cabau, J Jougon, B Badic, P Lozach, J P Bail, S Cappeliez, I El Nakadi, G Lebreton, A Alves, R Flamein, D Pezet, F Pipitone, B Stan-Iuga, N Contival, E Pappalardo, X Coueffe, S Msika, S Mantziari, N Demartines, F Hec, M Vanderbeken, W Tessier, N Briez, F Fredon, A Gainant, M Mathonnet, J M Bigourdan, S Mezoughi, C Ducerf, J Baulieux, J-Y Mabrut, O Baraket, G Poncet, M Adam, D Vaudoyer, P Jourdan Enfer, L Villeneuve, O Glehen, T Coste, J-M Fabre, F Marchal, R Frisoni, A Ayav, L Brunaud, L Bresler, C Cohen, O Aze, N Venissac, D Pop, J Mouroux, I Donici, M Prudhomme, E Felli, S Lisunfui, M Seman, G Godiris Petit, M Karoui, C Tresallet, F Ménégaux, J-C Vaillant, L Hannoun, B Malgras, D Lantuas, K Pautrat, M Pocard, P Valleur, J H Lefevre, N Chafai, P Balladur, M Lefrançois, Y Parc, F Paye, E Tiret, M Nedelcu, L Laface, T Perniceni, B Gayet, K Turner, A Filipello, J Porcheron, O Tiffet, N Kamlet, R Chemaly, A Klipfel, P Pessaux, C Brigand, S Rohr, N Carrère, C Da Re, F Dumont, D Goéré, D Elias, C Bertrand, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], and Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc)
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Population ,Adenocarcinoma ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,education ,Neoadjuvant therapy ,Chemotherapy ,education.field_of_study ,business.industry ,Mortality rate ,Hazard ratio ,Case-control study ,Cancer ,Middle Aged ,medicine.disease ,Neoadjuvant Therapy ,3. Good health ,Surgery ,Europe ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Case-Control Studies ,Propensity score matching ,Carcinoma, Squamous Cell ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Background The benefit of neoadjuvant chemotherapy (NCT) for early-stage oesophageal cancer is unknown. The aim of this study was to assess whether NCT improves the outcome of patients with stage I or II disease. Methods Data were collected from 30 European centres from 2000 to 2010. Patients who received NCT for stage I or II oesophageal cancer were compared with patients who underwent primary surgery with regard to postoperative morbidity, mortality, and overall and disease-free survival. Propensity score matching was used to adjust for differences in baseline characteristics. Results Of 1173 patients recruited (181 NCT, 992 primary surgery), 651 (55·5 per cent) had clinical stage I disease and 522 (44·5 per cent) had stage II disease. Comparisons of the NCT and primary surgery groups in the matched population (181 patients in each group) revealed in-hospital mortality rates of 4·4 and 5·5 per cent respectively (P = 0·660), R0 resection rates of 91·7 and 86·7 per cent (P = 0·338), 5-year overall survival rates of 47·7 and 38·6 per cent (hazard ratio (HR) 0·68, 95 per cent c.i. 0·49 to 0·93; P = 0·016), and 5-year disease-free survival rates of 44·9 and 36·1 per cent (HR 0·68, 0·50 to 0·93; P = 0·017). Conclusion NCT was associated with better overall and disease-free survival in patients with stage I or II oesophageal cancer, without increasing postoperative morbidity.
- Published
- 2016