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Patterns of recurrence after trimodality therapy for esophageal cancer.

Publication ,  Journal Article
Dorth, JA; Pura, JA; Palta, M; Willett, CG; Uronis, HE; D'Amico, TA; Czito, BG
Published in: Cancer
July 15, 2014

BACKGROUND: Patterns of failure after neoadjuvant chemoradiotherapy and surgery for esophageal cancer are poorly defined. METHODS: All patients in the current study were treated with trimodality therapy for nonmetastatic esophageal cancer from 1995 to 2009. Locoregional failure included lymph node failure (NF), anastomotic failure, or both. Abdominal paraaortic failure (PAF) was defined as disease recurrence at or below the superior mesenteric artery. RESULTS: Among 155 patients, the primary tumor location was the upper/middle esophagus in 18%, the lower esophagus in 32%, and the gastroesophageal junction in 50% (adenocarcinoma in 79% and squamous cell carcinoma in 21%) of patients. Staging methods included endoscopic ultrasound (73%), computed tomography (46%), and positron emission tomography/computed tomography (54%). Approximately 40% of patients had American Joint Committee on Cancer stage II disease and 60% had stage III disease. The median follow-up was 1.3 years. The 2-year locoregional control, event-free survival, and overall survival rates were 86%, 36%, and 48%, respectively. The 2-year NF rate was 14%, the isolated NF rate was 3%, and the anastomotic failure rate was 6%. The 2-year PAF rate was 9% and the isolated PAF rate was 5%. PAF was found to be increased among patients with gastroesophageal junction tumors (12% vs 6%), especially for the subset with ≥ 2 clinically involved lymph nodes at the time of diagnosis (19% vs 4%). CONCLUSIONS: Few patients experience isolated NF or PAF as their first disease recurrence. Therefore, it is unlikely that targeting additional regional lymph node basins with radiotherapy would significantly improve clinical outcomes.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

July 15, 2014

Volume

120

Issue

14

Start / End Page

2099 / 2105

Location

United States

Related Subject Headings

  • United States
  • Treatment Failure
  • Taxoids
  • Radiotherapy Dosage
  • Positron-Emission Tomography
  • Platinum Compounds
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
 

Citation

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Dorth, J. A., Pura, J. A., Palta, M., Willett, C. G., Uronis, H. E., D’Amico, T. A., & Czito, B. G. (2014). Patterns of recurrence after trimodality therapy for esophageal cancer. Cancer, 120(14), 2099–2105. https://doi.org/10.1002/cncr.28703
Dorth, Jennifer A., John A. Pura, Manisha Palta, Christopher G. Willett, Hope E. Uronis, Thomas A. D’Amico, and Brian G. Czito. “Patterns of recurrence after trimodality therapy for esophageal cancer.Cancer 120, no. 14 (July 15, 2014): 2099–2105. https://doi.org/10.1002/cncr.28703.
Dorth JA, Pura JA, Palta M, Willett CG, Uronis HE, D’Amico TA, et al. Patterns of recurrence after trimodality therapy for esophageal cancer. Cancer. 2014 Jul 15;120(14):2099–105.
Dorth, Jennifer A., et al. “Patterns of recurrence after trimodality therapy for esophageal cancer.Cancer, vol. 120, no. 14, July 2014, pp. 2099–105. Pubmed, doi:10.1002/cncr.28703.
Dorth JA, Pura JA, Palta M, Willett CG, Uronis HE, D’Amico TA, Czito BG. Patterns of recurrence after trimodality therapy for esophageal cancer. Cancer. 2014 Jul 15;120(14):2099–2105.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

July 15, 2014

Volume

120

Issue

14

Start / End Page

2099 / 2105

Location

United States

Related Subject Headings

  • United States
  • Treatment Failure
  • Taxoids
  • Radiotherapy Dosage
  • Positron-Emission Tomography
  • Platinum Compounds
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged