Titre
Surgical Outcomes After Neoadjuvant Chemoradiation Followed by Curative Surgery in Patients With Esophageal Cancer: An Intergroup Phase III Trial of the Swiss Group for Clinical Cancer Research (SAKK 75/08).
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
von Holzen, U.
Auteure/Auteur
Schmidt, S.
Auteure/Auteur
Hayoz, S.
Auteure/Auteur
Steffen, T.
Auteure/Auteur
Grieder, F.
Auteure/Auteur
Bartsch, D.
Auteure/Auteur
Schnider, A.
Auteure/Auteur
Knoefel, W.T.
Auteure/Auteur
Piessen, G.
Auteure/Auteur
Kettelhack, C.
Auteure/Auteur
Marti, W.R.
Auteure/Auteur
Schäfer, M.
Auteure/Auteur
Függer, R.
Auteure/Auteur
Köigsrainer, A.
Auteure/Auteur
Gloor, B.
Auteure/Auteur
Furrer, M.
Auteure/Auteur
Gérard, M.A.
Auteure/Auteur
Hawle, H.
Auteure/Auteur
Walz, M.K.
Auteure/Auteur
Alesina, P.
Auteure/Auteur
Ruhstaller, T.
Auteure/Auteur
Groupes de travail
Swiss Group for Clinical Cancer Research (SAKK), the German Esophageal Cancer Study Group, the Austrian Arbeitsgemeinschaft Medikamentöse Tumortherapie (AGMT), the Fédération Francophone de Cancérologie Digestive (FFCD)/Fédération de Recherche en Chirurgie (FRENCH)
Liens vers les personnes
Liens vers les unités
ISSN
1528-1140
Statut éditorial
Publié
Date de publication
2022-06-01
Volume
275
Numéro
6
Première page
1130
Dernière page/numéro d’article
1136
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Clinical Trial, Phase III ; Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
To assess the impact of surgical technique in regard to morbidity and mortality after neoadjuvant treatment for esophageal cancer.
The SAKK trial 75/08 was a multicenter phase III trial (NCT01107639) comparing induction chemotherapy followed by chemoradiation and surgery in patients with locally advanced esophageal cancer.
Patients in the control arm received induction chemotherapy with cisplatin and docetaxel, followed by concomitant chemoradiation therapy with cisplatin, docetaxel, and 45Gy. In the experimental arm, the same regimen was used with addition of cetuximab. After completion of neoadjuvant treatment, patients underwent esophagectomy. The experimental arm received adjuvant cetuximab. Surgical outcomes and complications were prospectively recorded and analyzed.
Total of 259 patients underwent esophagectomy. Overall complication rate was 56% and reoperation rate was 15% with no difference in complication rates for transthoracic versus transhiatal resections (56% vs 54%, P = 0.77), nor for video assisted thoracic surgeries (VATS) versus open transthoracic resections (67% vs 55%, P = 0.32). There was a trend to higher overall complication rates in squamous cell carcinoma versus adenocarcinoma (65% vs 51%, P = 0.035), and a significant difference in ARDS in squamous cell carcinoma with 14% versus 2% in adenocarcinoma (P = 0.0002). For patients with involved lymph nodes, a lymph node ratio of ≥0.1 was an independent predictor of PFS (HR 2.5, P = 0.01) and OS (HR 2.2, P = 0.03).
This trial showed no difference in surgical complication rates between transthoracic and transhiatal resections. For patients with involved lymph nodes, lymph node ratio was an independent predictor of progression free survival and overall survival.
The SAKK trial 75/08 was a multicenter phase III trial (NCT01107639) comparing induction chemotherapy followed by chemoradiation and surgery in patients with locally advanced esophageal cancer.
Patients in the control arm received induction chemotherapy with cisplatin and docetaxel, followed by concomitant chemoradiation therapy with cisplatin, docetaxel, and 45Gy. In the experimental arm, the same regimen was used with addition of cetuximab. After completion of neoadjuvant treatment, patients underwent esophagectomy. The experimental arm received adjuvant cetuximab. Surgical outcomes and complications were prospectively recorded and analyzed.
Total of 259 patients underwent esophagectomy. Overall complication rate was 56% and reoperation rate was 15% with no difference in complication rates for transthoracic versus transhiatal resections (56% vs 54%, P = 0.77), nor for video assisted thoracic surgeries (VATS) versus open transthoracic resections (67% vs 55%, P = 0.32). There was a trend to higher overall complication rates in squamous cell carcinoma versus adenocarcinoma (65% vs 51%, P = 0.035), and a significant difference in ARDS in squamous cell carcinoma with 14% versus 2% in adenocarcinoma (P = 0.0002). For patients with involved lymph nodes, a lymph node ratio of ≥0.1 was an independent predictor of PFS (HR 2.5, P = 0.01) and OS (HR 2.2, P = 0.03).
This trial showed no difference in surgical complication rates between transthoracic and transhiatal resections. For patients with involved lymph nodes, lymph node ratio was an independent predictor of progression free survival and overall survival.
PID Serval
serval:BIB_6265AA23C20E
PMID
Date de création
2020-10-31T13:08:52.925Z
Date de création dans IRIS
2025-05-21T01:25:52Z