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Interval Metastases After Neoadjuvant Chemoradiotherapy for Patients with Locally Advanced Esophageal Cancer: A Multicenter Observational Cohort Study.
van der Zijden, Charlène J; van der Sluis, Pieter C; Mostert, Bianca; Nuyttens, Joost J M E; van Lanschot, J Jan B; Spaander, Manon C W; Valkema, Roelf; Coene, Peter Paul L O; Dekker, Jan Willem T; Fiets, Willem E; Hartgrink, Hendrik H; Hazen, Wouter L; Kouwenhoven, Ewout A; Nieuwenhuijzen, Grard A P; Rosman, Camiel; van Sandick, Johanna W; Sosef, Meindert N; van der Zaag, Edwin S; Lagarde, Sjoerd M; Wijnhoven, Bas P L.
Afiliación
  • van der Zijden CJ; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. c.vanderzijden@erasmusmc.nl.
  • van der Sluis PC; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Mostert B; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
  • Nuyttens JJME; Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
  • van Lanschot JJB; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Spaander MCW; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Valkema R; Department of Nucleair Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Coene PPLO; Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
  • Dekker JWT; Department of Surgery, Reinier de Graaf Group, Delft, The Netherlands.
  • Fiets WE; Department of Medical Oncology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
  • Hartgrink HH; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
  • Hazen WL; Department of Gastroenterology, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands.
  • Kouwenhoven EA; Department of Surgery, Zorggroep Twente, Almelo, The Netherlands.
  • Nieuwenhuijzen GAP; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
  • Rosman C; Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
  • van Sandick JW; Department of Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
  • Sosef MN; Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.
  • van der Zaag ES; Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands.
  • Lagarde SM; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Wijnhoven BPL; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
Ann Surg Oncol ; 31(12): 7759-7766, 2024 Nov.
Article en En | MEDLINE | ID: mdl-39068317
ABSTRACT

BACKGROUND:

Despite trimodality treatment, 10% to 20% of patients with esophageal cancer experience interval metastases after surgery. Restaging may identify patients who should not proceed to surgery, as well as a subgroup with limited metastases for whom long-term disease-control can be obtained. This study aimed to determine the proportion of patients with interval metastases after neoadjuvant chemoradiotherapy (nCRT) and to evaluate treatment and survival.

METHODS:

Patients who had cT2-4aN0-3M0 esophageal cancer treated with nCRT were identified from a trial database. Metastases detected up to 14 weeks after nCRT on 18F-FDG-PET/CT or during surgery were categorized as oligometastases (≤3 lesions located in one single organ or one extra-regional lymph node station) or as non-oligometastases. The primary outcome was the proportion of patients with metastases after nCRT. The secondary outcomes were overall survival (OS) and the site and treatment of metastases.

RESULTS:

Between 2013 and 2021, 973 patients received nCRT, and 10.3% had interval metastases. Of 100 patients, 30 (30%) had oligometastases, located mostly in non-regional lymph nodes (33.3%) or bones (26.7%). The median OS of this group was 13.8 months (95% confidence interval [CI] 9.2-27.1 months). Of 30 patients, 12 (40%) with oligometastases underwent potentially curative treatment, with a median OS of 22.8 months (95% CI 10.4-NA). The patients with non-oligometastases underwent mostly systemic therapy or BSC and had a median OS of 9 months (95% CI 7.4-10.9 months).

CONCLUSIONS:

Interval metastases were detected in about 10% of patients after nCRT, underscoring the importance of re-staging with 18F-FDG-PET/CT for those who proceed to surgery. A favorable survival might be accomplished for a subgroup of patients with oligometastases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Esofágicas / Terapia Neoadyuvante / Tomografía Computarizada por Tomografía de Emisión de Positrones Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Esofágicas / Terapia Neoadyuvante / Tomografía Computarizada por Tomografía de Emisión de Positrones Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos