Imperial College London
Alternate

ProfessorGeorgeHanna

Faculty of Medicine, Department of Surgery & Cancer

Head of Department of Surgery and Cancer
 
 
 
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Contact

 

+44 (0)20 7594 3396g.hanna

 
 
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Assistant

 

Ms Aoibheann Byrne +44 (0)20 7594 3396

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Markar:2016:annonc/mdw560,
author = {Markar, SR and Noordman, BJ and Mackenzie, H and Findlay, JM and Boshier, PR and Ni, M and Steyerberg, EW and van, der Gaast A and Hulshof, MC and Maynard, N and van, Berge Henegouwen MI and Wijnhoven, BP and Reynolds, JV and Van, Lanschot JJ and Hanna, GB},
doi = {annonc/mdw560},
journal = {Annals of Oncology},
pages = {519--527},
title = {Multimodality treatment for esophageal adenocaricnoma: multi-center propensity-score matched study.},
url = {http://dx.doi.org/10.1093/annonc/mdw560},
volume = {28},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: The primary aim of this study was to compare survival from neoadjuvant chemoradiotherapy plus surgery (NCRS) versus neoadjuvant chemotherapy plus surgery (NCS) for the treatment of esophageal or junctional adenocarcinoma. The secondary aims were to compare pathological effects, short-term mortality and morbidity, and to evaluate the effect of lymph node harvest upon survival in both treatment groups. METHODS: Data were collected from 10 European centers from 2001 to 2012. Six hundred and eight patients with stage II or III oesophageal or oesophago-gastric junctional adenocarcinoma were included; 301 in the NCRS group and 307 in the NCS group. Propensity score matching and Cox regression analyses were used to compensate for differences in baseline characteristics. RESULTS: NCRS resulted in significant pathological benefits with more ypT0 (26.7% versus 5%; P < 0.001), more ypN0 (63.3% versus 32.1%; P < 0.001), and reduced R1/2 resection margins (7.7% versus 21.8%; P < 0.001). Analysis of short-term outcomes showed no statistically significant differences in 30-day or 90-day mortality, but increased incidence of anastomotic leak (23.1% versus 6.8%; P < 0.001) in NCRS patients.There were no statistically significant differences between the groups in 3-year overall survival (57.9% versus 53.4%; Hazard Ratio (HR)= 0.89, 95%C.I. 0.67-1.17, P = 0.391) nor disease-free survival (52.9% versus 48.9%; HR = 0.90, 95%C.I. 0.69-1.18, P = 0.443). The pattern of recurrence was also similar (P = 0.660). There was a higher lymph node harvest in the NCS group (27 versus 14; P < 0.001), which was significantly associated with a lower recurrence rate and improved disease free survival within the NCS group. CONCLUSION: The survival differences between NCRS and NCS maybe modest, if present at all, for the treatment of locally advanc
AU  - Markar,SR
AU  - Noordman,BJ
AU  - Mackenzie,H
AU  - Findlay,JM
AU  - Boshier,PR
AU  - Ni,M
AU  - Steyerberg,EW
AU  - van,der Gaast A
AU  - Hulshof,MC
AU  - Maynard,N
AU  - van,Berge Henegouwen MI
AU  - Wijnhoven,BP
AU  - Reynolds,JV
AU  - Van,Lanschot JJ
AU  - Hanna,GB
DO  - annonc/mdw560
EP  - 527
PY  - 2016///
SN  - 1569-8041
SP  - 519
TI  - Multimodality treatment for esophageal adenocaricnoma: multi-center propensity-score matched study.
T2  - Annals of Oncology
UR  - http://dx.doi.org/10.1093/annonc/mdw560
UR  - http://www.ncbi.nlm.nih.gov/pubmed/28039180
UR  - http://hdl.handle.net/10044/1/44596
VL  - 28
ER  -
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