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The Benefit of Chemotherapy in Esophageal Cancer Patients With Residual Disease After Trimodality Therapy.

Publication ,  Journal Article
Kim, GJ; Koshy, M; Hanlon, AL; Horiba, MN; Edelman, MJ; Burrows, WM; Battafarano, RJ; Suntharalingam, M
Published in: Am J Clin Oncol
April 2016

INTRODUCTION: The objective of this retrospective study was to determine the potential benefits of chemotherapy in esophageal cancer patients treated with chemoradiation followed by surgery. MATERIALS AND METHODS: At our institution, 145 patients completed trimodality therapy from 1993 to 2009. Neoadjuvant treatment predominantly consisted of 5-fluorouracil and cisplatin with a concurrent median radiation dose of 50.4 Gy. Sixty-two patients received chemotherapy postoperatively. The majority (49/62) received 3 cycles of docetaxel. RESULTS: Within the entire cohort, a 5-year overall survival (OS) benefit was found in those who received postoperative chemotherapy, OS 37.1% versus 18.0% (P=0.024). The response after neoadjuvant chemoradiation was as follows: 33.8% had a pathologic complete response and 62.8% with residual disease. A 5-year OS and cause-specific survival (CSS) advantage were associated with postoperative chemotherapy among those with macroscopic residual disease after neoadjuvant therapy: OS 38.7% versus 13.9% (P=0.016), CSS 42.8% versus 18.8% (P=0.048). This benefit was not seen in those with a pathologic complete response or those with microscopic residual. A stepwise multivariate Cox regression model evaluating the partial response group revealed that postoperative chemotherapy and M stage were independent predictors of overall and CSS. CONCLUSIONS: This analysis revealed that patients with gross residual disease after trimodality therapy for esophageal cancer who received postoperative chemotherapy had an improved overall and CSS. These data suggest that patients with residual disease after trimodality therapy and a reasonable performance status may benefit from postoperative chemotherapy. Prospective trials are needed to confirm these results to define the role of postoperative treatment after trimodality therapy.

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Published In

Am J Clin Oncol

DOI

EISSN

1537-453X

Publication Date

April 2016

Volume

39

Issue

2

Start / End Page

136 / 141

Location

United States

Related Subject Headings

  • Taxoids
  • Retrospective Studies
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kim, G. J., Koshy, M., Hanlon, A. L., Horiba, M. N., Edelman, M. J., Burrows, W. M., … Suntharalingam, M. (2016). The Benefit of Chemotherapy in Esophageal Cancer Patients With Residual Disease After Trimodality Therapy. Am J Clin Oncol, 39(2), 136–141. https://doi.org/10.1097/COC.0000000000000036
Kim, Grace J., Matthew Koshy, Alexandra L. Hanlon, M Naomi Horiba, Martin J. Edelman, Whitney M. Burrows, Richard J. Battafarano, and Mohan Suntharalingam. “The Benefit of Chemotherapy in Esophageal Cancer Patients With Residual Disease After Trimodality Therapy.Am J Clin Oncol 39, no. 2 (April 2016): 136–41. https://doi.org/10.1097/COC.0000000000000036.
Kim GJ, Koshy M, Hanlon AL, Horiba MN, Edelman MJ, Burrows WM, et al. The Benefit of Chemotherapy in Esophageal Cancer Patients With Residual Disease After Trimodality Therapy. Am J Clin Oncol. 2016 Apr;39(2):136–41.
Kim, Grace J., et al. “The Benefit of Chemotherapy in Esophageal Cancer Patients With Residual Disease After Trimodality Therapy.Am J Clin Oncol, vol. 39, no. 2, Apr. 2016, pp. 136–41. Pubmed, doi:10.1097/COC.0000000000000036.
Kim GJ, Koshy M, Hanlon AL, Horiba MN, Edelman MJ, Burrows WM, Battafarano RJ, Suntharalingam M. The Benefit of Chemotherapy in Esophageal Cancer Patients With Residual Disease After Trimodality Therapy. Am J Clin Oncol. 2016 Apr;39(2):136–141.

Published In

Am J Clin Oncol

DOI

EISSN

1537-453X

Publication Date

April 2016

Volume

39

Issue

2

Start / End Page

136 / 141

Location

United States

Related Subject Headings

  • Taxoids
  • Retrospective Studies
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans