Role of neoadjuvant treatment in clinical T2N0M0 oesophageal cancer: results from a retrospective multi-center European study - Université de Lorraine Access content directly
Journal Articles European Journal of Cancer Year : 2016

Role of neoadjuvant treatment in clinical T2N0M0 oesophageal cancer: results from a retrospective multi-center European study

Sheraz Markar (1) , Caroline Gronnier (2, 3) , Arnaud Pasquer (4) , Alain Duhamel (5, 6) , Hélène Beal (5, 6) , Jérémie Thereaux (7) , Johan Gagnière (8) , Gil Lebreton (9) , Cécile Brigand (10) , B. Meunier (11) , Denis Collet (12) , Christophe Mariette (2) , Abdennahceur Dhahri (13) , Delphine Lignier , Cyril Cossé , Marc Regimbeau , Magalie Cabau (14) , Jacques Jougon , Bogdan Badic (7) , Patrick Lozach , Pierre Bail (15) , Serge Cappeliez , Issam El Nakadi , Arnaud Alves , Renaud Flamein (16) , Denis Pezet (8) , Federica Pipitone , Bogdan Stan-Iuga (17) , Nicolas Contival , Eric Pappalardo , Simon Msika (18) , Styliani Mantziari , Nicolas Demartines , Flora Hec , Marguerite Vanderbeken , Williams Tessier , Nicolas Briez (19) , Fabien Fredon , Alain Gainant (20) , Muriel Mathonnet (21, 20) , Marc Bigourdan , Salim Mezoughi , Christian Ducerf (22) , Jacques Baulieux , Jean-Yves Mabrut (23) , Oussama Baraket , Gilles Poncet (24) , Mustapha Adam (25) , Delphine Vaudoyer , Peggy Jourdan Enfer , Laurent Villeneuve (26) , Olivier Glehen (27) , Thibault Coste , Michel Fabre (28) , Frédéric Marchal (29) , Romain Frisoni , Ahmet Ayav (30) , Laurent Brunaud (31) , Laurent Bresler (30, 31) , Charlotte Cohen (32) , Olivier Aze , Nicolas Venissac (33) , Daniel Pop (34) , Jerôme Mouroux (35) , Ion Donici , Michel Prudhomme (36) , Emanuele Felli , Stéphanie Lisunfui , Marie Seman , Gaelle Godiris Petit (37) , Mehdi Karoui (38) , Christophe Trésallet (39) , Fabrice Menegaux (39) , Jean-Christophe Vaillant (40) , Laurent Hannoun (39) , Brice Malgras , Denis Lantuas , Karine Pautrat (41) , Marc Pocard , Patrice Valleur (42) , Najim Chafai (43) , Pierre Balladur (44) , Magalie Lefrancois (43) , Yann Parc (43) , François Paye (43) , Emmanuel Tiret (43) , Marius Nedelcu (45) , Letizia Laface , Thierry Perniceni (46) , Brice Gayet (47) , Alexandre Filipello , Jack Porcheron (48) , Olivier Tiffet , Noémie Kamlet , Rodrigue Chemaly , Amandine Klipfel , Patrick Pessaux (49) , Serge Rohr (50) , Nicolas Carrère , Chiara da Re , Frederic Dumont , Diane Goéré (51) , Dominique Elias (52) , Claude P. Bertrand (53)
1 Imperial College London
2 JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837
3 Hôpital Claude Huriez [Lille]
4 Hôpital Edouard Herriot [CHU - HCL]
5 SIRIC-ONCOLille - Site de Recherche Intégrée en Cancérologie
6 Service de Biostatistiques [CHRU Lille]
7 CGV - BREST - Service de Chirurgie Générale et Viscérale
8 Chirurgie digestive et hépatobiliaire
9 Hôpital Côte de Nacre [CHU Caen]
10 Hôpital de Hautepierre [Strasbourg]
11 Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes]
12 Service de chirurgie digestive
13 IMP - Ingénierie des Matériaux Polymères
14 CIC-IT Bordeaux
15 UBO - Université de Brest
16 Département de chirurgie digestive
17 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
18 Hôpital Louis Mourier - AP-HP [Colombes]
19 Service de Chirurgie Générale et Digestive[Lille]
20 Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges]
21 HCP - Homéostasie Cellulaire et Pathologies
22 UPMC - Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie
23 Département de chirurgie digestive
24 Unité de Chirurgie Colorectale
25 EVS - Environnement, Ville, Société
26 IMER - Pôle Information Médicale Evaluation Recherche
27 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
28 CREN - Centre de recherche en éducation de Nantes
29 CRAN - Centre de Recherche en Automatique de Nancy
30 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
31 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
32 Chelsea and Westminster Hospital
33 NICE - Chirurgie Thoracique - Service de Chirurgie Thoracique
34 UVT - Universitatea de Vest din Timișoara [România] = West University of Timișoara [Romania] = Université Ouest de Timișoara [Roumanie]
35 Service de Chirurgie thoracique
36 Département de chirurgie digestive
37 Lab-STICC_UBS_CID_DECIDE
38 Service d'hépato-gastro-entérologie [APHP Henri Mondor]
39 CHU Pitié-Salpêtrière [AP-HP]
40 LAMIA - Laboratoire de Mathématiques Informatique et Applications
41 Department of Gastroenterological Surgery
42 Service de Chirurgie Digestive
43 CHU Saint-Antoine [AP-HP]
44 UMRS893 - Centre de Recherche Saint-Antoine
45 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
46 Département de chirurgie digestive
47 Departement medico-chirurgical de pathologie digestive
48 Chirurgie digestive
49 Départment de Statistiques Bio-médicales
50 Service de chirurgie digestive [Strasbourg-Hautepierre]
51 Département de chirurgie générale [Gustave Roussy]
52 IGR - Institut Gustave Roussy
53 R&D, centre de Fresnes
Cécile Brigand
  • Function : Author
  • PersonId : 907735
Abdennahceur Dhahri
  • Function : Author
  • PersonId : 1151807
Delphine Lignier
  • Function : Author
  • PersonId : 1151812
Cyril Cossé
  • Function : Author
Marc Regimbeau
  • Function : Author
Magalie Cabau
  • Function : Author
Jacques Jougon
  • Function : Author
Patrick Lozach
  • Function : Author
Pierre Bail
  • Function : Author
Serge Cappeliez
  • Function : Author
Issam El Nakadi
  • Function : Author
Arnaud Alves
  • Function : Author
Federica Pipitone
  • Function : Author
Nicolas Contival
  • Function : Author
Eric Pappalardo
  • Function : Author
Styliani Mantziari
  • Function : Author
Nicolas Demartines
  • Function : Author
Flora Hec
  • Function : Author
Marguerite Vanderbeken
  • Function : Author
Williams Tessier
  • Function : Author
Fabien Fredon
  • Function : Author
Marc Bigourdan
  • Function : Author
Salim Mezoughi
  • Function : Author
Jacques Baulieux
  • Function : Author
Jean-Yves Mabrut
  • Function : Author
  • PersonId : 907740
Oussama Baraket
  • Function : Author
Delphine Vaudoyer
  • Function : Author
Peggy Jourdan Enfer
  • Function : Author
Thibault Coste
Michel Fabre
Romain Frisoni
  • Function : Author
Ahmet Ayav
  • Function : Author
  • PersonId : 762396
  • IdRef : 09518399X
Olivier Aze
  • Function : Author
Ion Donici
  • Function : Author
Michel Prudhomme
  • Function : Author
  • PersonId : 907744
Emanuele Felli
  • Function : Author
Stéphanie Lisunfui
  • Function : Author
Marie Seman
  • Function : Author
Fabrice Menegaux
  • Function : Author
  • PersonId : 982379
Brice Malgras
Denis Lantuas
  • Function : Author
Marc Pocard
Patrice Valleur
  • Function : Author
  • PersonId : 947715
Letizia Laface
  • Function : Author
Alexandre Filipello
  • Function : Author
Olivier Tiffet
  • Function : Author
Noémie Kamlet
  • Function : Author
Rodrigue Chemaly
  • Function : Author
Amandine Klipfel
  • Function : Author
Patrick Pessaux
Nicolas Carrère
Chiara da Re
  • Function : Author
Frederic Dumont
  • Function : Author

Abstract

Aims: The aims of this study were to compare short-and long-term outcomes for clinical T2N0 oesophageal cancer with analysis of (i) primary surgery (S) versus neoadjuvant therapy plus surgery (NS), (ii) squamous cell carcinoma and adenocarcinoma subsets; and (iii) neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy. Methods: Data were collected from 30 European centres from 2000 to 2010. Among 2944 included patients, 355 patients (12.1%) had cT2N0 disease; 285 (S) and 70 (NS), were compared in terms of short-and long-term outcomes. Propensity score matching analyses were used to compensate for differences in baseline characteristics. Results: No significant differences between the groups were shown in terms of in hospital morbidity and mortality. Nodal disease was observed in 50% of S-group at the time of surgery, with 20% pN2/N3. Utilisation of neoadjuvant therapy was associated with significant tumour downstaging as reflected by increases in pT0, pN0 and pTNM stage 0 disease, this effect was further enhanced with neoadjuvant chemoradiotherapy. After adjustment on propensity score and confounding factors, for all patients and subset analysis of squamous cell and adenocarcinoma, neoadjuvant therapy had no significant effect upon survival or recurrence (overall, loco-regional, distant or mixed) compared to surgery alone. There were no significant differences between neoadjuvant chemotherapy and chemoradiotherapy in short-or long-term outcomes. Conclusion: The results of this study suggest that a surgery alone treatment approach should be recommended as the primary treatment approach for cT2N0 oesophageal cancer despite 50% of patients having nodal disease at the time of surgery.
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Dates and versions

hal-01666517 , version 1 (18-12-2017)

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Sheraz Markar, Caroline Gronnier, Arnaud Pasquer, Alain Duhamel, Hélène Beal, et al.. Role of neoadjuvant treatment in clinical T2N0M0 oesophageal cancer: results from a retrospective multi-center European study. European Journal of Cancer, 2016, 56, pp.59-68. ⟨10.1016/j.ejca.2015.11.024⟩. ⟨hal-01666517⟩
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