TY - JOUR
T1 - Delaying surgery after neoadjuvant chemoradiotherapy does not significantly influence postoperative morbidity or oncological outcome in patients with oesophageal adenocarcinoma
AU - Kathiravetpillai, N.
AU - Koeter, M.
AU - van der Sangen, M. J. C.
AU - Creemers, G. J.
AU - Luyer, M. D. P.
AU - Rutten, H. J. T.
AU - Nieuwenhuijzen, G. A. P.
PY - 2016/8
Y1 - 2016/8
N2 - 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.
AB - 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.
KW - Oesophageal adenocarcinoma
KW - Neoadjuvant chemoradiotherapy
KW - Interval
KW - Postoperative outcome
U2 - 10.1016/j.ejso.2016.03.033
DO - 10.1016/j.ejso.2016.03.033
M3 - Article
SN - 0748-7983
VL - 42
SP - 1183
EP - 1190
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 8
ER -