Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer

J. De Vos-Geelen; S.M.E. Geurts; G.A.P. Nieuwenhuijzen; F.E.M. Voncken; J.A. Bogers; P.M. Braam; C.T. Muijs; M.A. De Jong; N. Kasperts; T. Rozema; G.J. Blom; S.A.W. Bouwense; L.B.J. Valkenburg-Van Iersel; P.M. Jeene; F.J.P. Hoebers; V.C.G. Tjan-Heijnen

doi:10.1016/j.ejso.2021.02.001

Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer

J. De Vos-Geelen^*, S.M.E. Geurts, G.A.P. Nieuwenhuijzen, F.E.M. Voncken, J.A. Bogers, P.M. Braam, C.T. Muijs, M.A. De Jong, N. Kasperts, T. Rozema, G.J. Blom, S.A.W. Bouwense, L.B.J. Valkenburg-Van Iersel, P.M. Jeene, F.J.P. Hoebers, V.C.G. Tjan-Heijnen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction: The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer.Materials and methods: Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in 11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses.Results: In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8-61.5 months), 58% (95% CI 48-66), and 49% (95% CI 40-57), respectively. Three- and five-year risk of recurrence were respectively 40% (95% CI 31-48), and 45% (95% CI 36-54). Three- and five-year risk of LRR were 26% (95% CI 19-33), and 30% (95% CI 22-38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached).Conclusion: In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years. (C) 2021 The Authors. Published by Elsevier Ltd.

Original language	English
Pages (from-to)	2016-2022
Number of pages	7
Journal	European Journal of Surgical Oncology
Volume	47
Issue number	8
DOIs	https://doi.org/10.1016/j.ejso.2021.02.001
Publication status	Published - 1 Aug 2021

Keywords

Esophagus
Cervical
Upper thoracic
Squamous cell cancer
Chemoradiotherapy
Relapse
SQUAMOUS-CELL CARCINOMA
CONCURRENT CHEMORADIATION
RADIOTHERAPY
CHEMOTHERAPY
CISPLATIN
CHEMORADIOTHERAPY
SURGERY
THERAPY
IMPACT

Access to Document

10.1016/j.ejso.2021.02.001Licence: CC BY

Cite this

De Vos-Geelen, J., Geurts, S. M. E., Nieuwenhuijzen, G. A. P., Voncken, F. E. M., Bogers, J. A., Braam, P. M., Muijs, C. T., De Jong, M. A., Kasperts, N., Rozema, T., Blom, G. J., Bouwense, S. A. W., Valkenburg-Van Iersel, L. B. J., Jeene, P. M., Hoebers, F. J. P., & Tjan-Heijnen, V. C. G. (2021). Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer. European Journal of Surgical Oncology, 47(8), 2016-2022. https://doi.org/10.1016/j.ejso.2021.02.001

@article{670ba0a3abac4b2ca0fb9d40593e8965,

title = "Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer",

abstract = "Introduction: The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer.Materials and methods: Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in 11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses.Results: In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8-61.5 months), 58% (95% CI 48-66), and 49% (95% CI 40-57), respectively. Three- and five-year risk of recurrence were respectively 40% (95% CI 31-48), and 45% (95% CI 36-54). Three- and five-year risk of LRR were 26% (95% CI 19-33), and 30% (95% CI 22-38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached).Conclusion: In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years. (C) 2021 The Authors. Published by Elsevier Ltd.",

keywords = "Esophagus, Cervical, Upper thoracic, Squamous cell cancer, Chemoradiotherapy, Relapse, SQUAMOUS-CELL CARCINOMA, CONCURRENT CHEMORADIATION, RADIOTHERAPY, CHEMOTHERAPY, CISPLATIN, CHEMORADIOTHERAPY, SURGERY, THERAPY, IMPACT",

author = "{De Vos-Geelen}, J. and S.M.E. Geurts and G.A.P. Nieuwenhuijzen and F.E.M. Voncken and J.A. Bogers and P.M. Braam and C.T. Muijs and {De Jong}, M.A. and N. Kasperts and T. Rozema and G.J. Blom and S.A.W. Bouwense and {Valkenburg-Van Iersel}, L.B.J. and P.M. Jeene and F.J.P. Hoebers and V.C.G. Tjan-Heijnen",

note = "Funding Information: JV has served as a consultant for AstraZeneca, MSD, Pierre Fabre, and Servier, and has received institutional research funding from Servier. All outside the submitted work. Funding Information: SG has received institutional research funding from Roche, Pfizer, Novartis, and Eli Lilly. All outside the submitted work. Funding Information: VT has received honoraria/travel grants from Roche, Novartis, Pfizer, Lilly, and Accord Healthcare, and has received institutional research funding from AstraZeneca, Roche, Pfizer, Novartis, Eisai, and Lilly. All outside the submitted work. Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = aug,

day = "1",

doi = "10.1016/j.ejso.2021.02.001",

language = "English",

volume = "47",

pages = "2016--2022",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

publisher = "ELSEVIER SCI LTD",

number = "8",

}

De Vos-Geelen, J , Geurts, SME, Nieuwenhuijzen, GAP, Voncken, FEM, Bogers, JA, Braam, PM, Muijs, CT, De Jong, MA, Kasperts, N, Rozema, T, Blom, GJ, Bouwense, SAW , Valkenburg-Van Iersel, LBJ, Jeene, PM, Hoebers, FJP & Tjan-Heijnen, VCG 2021, 'Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer', European Journal of Surgical Oncology, vol. 47, no. 8, pp. 2016-2022. https://doi.org/10.1016/j.ejso.2021.02.001

TY - JOUR

T1 - Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer

AU - De Vos-Geelen, J.

AU - Geurts, S.M.E.

AU - Nieuwenhuijzen, G.A.P.

AU - Voncken, F.E.M.

AU - Bogers, J.A.

AU - Braam, P.M.

AU - Muijs, C.T.

AU - De Jong, M.A.

AU - Kasperts, N.

AU - Rozema, T.

AU - Blom, G.J.

AU - Bouwense, S.A.W.

AU - Valkenburg-Van Iersel, L.B.J.

AU - Jeene, P.M.

AU - Hoebers, F.J.P.

AU - Tjan-Heijnen, V.C.G.

N1 - Funding Information: JV has served as a consultant for AstraZeneca, MSD, Pierre Fabre, and Servier, and has received institutional research funding from Servier. All outside the submitted work. Funding Information: SG has received institutional research funding from Roche, Pfizer, Novartis, and Eli Lilly. All outside the submitted work. Funding Information: VT has received honoraria/travel grants from Roche, Novartis, Pfizer, Lilly, and Accord Healthcare, and has received institutional research funding from AstraZeneca, Roche, Pfizer, Novartis, Eisai, and Lilly. All outside the submitted work. Publisher Copyright: © 2021 The Authors

PY - 2021/8/1

Y1 - 2021/8/1

N2 - Introduction: The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer.Materials and methods: Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in 11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses.Results: In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8-61.5 months), 58% (95% CI 48-66), and 49% (95% CI 40-57), respectively. Three- and five-year risk of recurrence were respectively 40% (95% CI 31-48), and 45% (95% CI 36-54). Three- and five-year risk of LRR were 26% (95% CI 19-33), and 30% (95% CI 22-38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached).Conclusion: In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years. (C) 2021 The Authors. Published by Elsevier Ltd.

AB - Introduction: The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer.Materials and methods: Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in 11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses.Results: In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8-61.5 months), 58% (95% CI 48-66), and 49% (95% CI 40-57), respectively. Three- and five-year risk of recurrence were respectively 40% (95% CI 31-48), and 45% (95% CI 36-54). Three- and five-year risk of LRR were 26% (95% CI 19-33), and 30% (95% CI 22-38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached).Conclusion: In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years. (C) 2021 The Authors. Published by Elsevier Ltd.

KW - Esophagus

KW - Cervical

KW - Upper thoracic

KW - Squamous cell cancer

KW - Chemoradiotherapy

KW - Relapse

KW - SQUAMOUS-CELL CARCINOMA

KW - CONCURRENT CHEMORADIATION

KW - RADIOTHERAPY

KW - CHEMOTHERAPY

KW - CISPLATIN

KW - CHEMORADIOTHERAPY

KW - SURGERY

KW - THERAPY

KW - IMPACT

U2 - 10.1016/j.ejso.2021.02.001

DO - 10.1016/j.ejso.2021.02.001

M3 - Article

C2 - 33583629

SN - 0748-7983

VL - 47

SP - 2016

EP - 2022

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 8

ER -