Delaying surgery after neoadjuvant chemoradiotherapy does not significantly influence postoperative morbidity or oncological outcome in patients with oesophageal adenocarcinoma

N. Kathiravetpillai, M. Koeter, M. J. C. van der Sangen, G. J. Creemers, M. D. P. Luyer, H. J. T. Rutten, G. A. P. Nieuwenhuijzen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Patients with resectable oesophageal cancer are treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery within 3-8 weeks. In practice, surgery is often delayed for various reasons. The aim of this study was to evaluate whether delaying surgery beyond 8 weeks has an effect on postoperative morbidity, long-term survival, and pathologic response in patients treated for oesophageal ADC.Patients who underwent nCRT followed by surgery, for cT1-3, N0-3, M0 ADC between 2001 and 2014 were retrospectively included from a prospectively obtained database. Patients with a time from the end of nCRT to surgery (TTS) ?8 weeks were compared with patients with a TTS >8 weeks.Of 190 patients, 65 had a TTS ?8 weeks, and 125 had a TTS >8 weeks. Patient characteristics were comparable for both groups, but patients with TTS >8 weeks exhibited higher ASA scores (p?=?0.013) and more comorbidities (p?=?0.007). Multivariate analysis revealed that TTS did not significantly influence postoperative morbidity, pathologic complete response rates, and five-year survival rates (42% in patients with TTS ?8 weeks and 37% in patients with TTS >8 weeks).Delaying surgery beyond 8 weeks after nCRT did not significantly influence postoperative morbidity, pathologic response, and survival in patients with non-metastatic ADC. Therefore, it appears reasonable to postpone surgery beyond 8 weeks in patients who have not yet recovered from nCRT. However, if the patient is fit for surgery, postponing surgery does not have any additional advantages.
Original languageEnglish
Pages (from-to)1183-1190
JournalEuropean Journal of Surgical Oncology
Volume42
Issue number8
DOIs
Publication statusPublished - Aug 2016

Keywords

  • Oesophageal adenocarcinoma
  • Neoadjuvant chemoradiotherapy
  • Interval
  • Postoperative outcome

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