Association Between Clinically Staged Node-Negative Esophageal Adenocarcinoma and Overall Survival Benefit From Neoadjuvant Chemoradiation
- Emmanuel Gabriel 1, Kristopher Attwood 2, William Du 1, Rebecca Tuttle 1, Raed M Alnaji 1, Steven Nurkin 1, Usha Malhotra 3, Steven N Hochwald 1, Moshim Kukar 1
- 1Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York.
- 2Department of Biostatistics, New Center for Excellence, Buffalo, New York.
- 3Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, New York.
- 0Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York.
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View abstract on PubMed
Summary
This summary is machine-generated.Neoadjuvant chemoradiation significantly improves overall survival for patients with node-positive (cN+) esophageal adenocarcinoma. However, those with node-negative (cN-) tumors do not show a survival benefit from this treatment compared to surgery alone.
Area Of Science
- Oncology
- Surgical Oncology
- Gastroenterology
Background
- Neoadjuvant chemoradiation (NACR) is standard for locally advanced esophageal cancer.
- Identifying subsets benefiting most from NACR, particularly regarding overall survival (OS), remains crucial.
Purpose Of The Study
- To evaluate the impact of NACR on oncologic outcomes in esophageal adenocarcinoma.
- To stratify treatment effects based on clinical nodal status (cN- vs cN+).
Main Methods
- Retrospective analysis of 1309 esophageal adenocarcinoma patients (1998-2006).
- Comparison of NACR + surgery vs. surgery alone.
- Propensity score-adjusted analysis by clinical nodal status.
Main Results
- NACR + surgery showed improved 3-year OS (49% vs 38%, P<.001).
- cN+ patients receiving NACR had significantly better OS (HR 0.52, P<.001).
- No significant OS difference was observed for cN- patients (HR 0.84, P=.22).
Conclusions
- Neoadjuvant chemoradiation offers significant survival benefits for cN+ esophageal adenocarcinoma.
- NACR does not improve OS for cN- esophageal adenocarcinoma patients compared to surgery alone.
- Findings suggest reconsidering NACR for cN- esophageal adenocarcinoma.
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