Delayed Esophagectomy After Chemoradiation Is Not Associated With Increased Mortality or Recurrence.

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Esophageal cancer treatment often involves neoadjuvant chemoradiation (CROSS) followed by esophagectomy.
• The optimal timing for esophagectomy after CROSS is debated.
• Delayed surgery may increase patient comorbidities and complicate recovery.

Purpose of the Study:

• To evaluate the impact of delayed esophagectomy on overall survival in esophageal cancer patients treated with CROSS.
• To compare outcomes between patients undergoing esophagectomy within 60 days versus after 60 days post-CROSS.

Main Methods:

• Retrospective analysis of a prospective database of 197 esophageal cancer patients who underwent CROSS and esophagectomy.
• Comparison of preoperative characteristics, postoperative adverse events, recurrence, and survival rates between a standard group (≤60 days) and a delayed group (>60 days).

Main Results:

• No significant differences in overall survival or recurrence rates were observed between the standard and delayed surgery groups.
• Delayed esophagectomy patients were older, had higher comorbidity scores, and more pre-existing conditions.
• The delayed group experienced increased major postoperative adverse events (OR 2.26).

Conclusions:

• A delay in esophagectomy beyond 60 days after CROSS is not associated with worse oncologic outcomes (recurrence or survival).
• Despite increased comorbidities and postoperative complications, delayed surgery did not negatively impact survival.
• These findings support flexibility in surgical timing after CROSS therapy.