Impact of Neoadjuvant Chemoradiotherapy on Postoperative Outcomes After Esophageal Cancer Resection
Caroline Gronnier
(1, 2, 3)
,
Boris Tréchot
(2)
,
Alain Duhamel
(4, 5)
,
Jean-Yves Mabrut
(6)
,
Jean-Pierre Bail
(7)
,
Nicolas Carrère
(8)
,
Jérémie Lefevre
(9)
,
Cécile Brigand
(10)
,
Christophe Vaillant
(11)
,
Mustapha Adham
(12)
,
Simon Msika
(13)
,
Nicolas Demartines
(14)
,
Issam El Nakadi
(15)
,
Guillaume Piessen
(1, 2, 3)
,
B. Meunier
(16)
,
Denis Collet
(17)
,
Christophe Mariette
(1, 2, 3, 4)
,
G. Luc
,
Magalie Cabau
(18)
,
Jacques Jougon
(19)
,
Bogdan Badic
(20)
,
Patrick Lozach
,
Serge Cappeliez
,
G. Lebreton
,
A. Alves
,
Renaud Flamein
(21)
,
Denis Pezet
(22)
,
Federica Pipitone
,
Nicolas Contival
,
Eric Pappalardo
,
Styliani Mantziari
,
F. Hec
,
Marguerite Vanderbeken
,
Williams Tessier
,
Nicolas Briez
(23)
,
F Fredon
,
Alain Gainant
(24)
,
Muriel Mathonnet
(25)
,
Jm Bigourdan
,
Salim Mezoughi
,
C. Ducerf
(26)
,
Jacques Baulieux
,
Arnaud Pasquer
(12)
,
Oussama Baraket
,
Gilles Poncet
(27)
,
Delphine Vaudoyer
,
J Enfer
,
L Villeneuve
,
O. Glehen
(28)
,
T Coste
,
J.M Fabre
(29)
,
F Marchal
,
Romain Frisoni
,
Ahmet Ayav
(30)
,
Laurent Brunaud
(30, 31)
,
Laurent Bresler
(30)
,
C Cohen
,
Olivier Aze
,
Nicolas Vénissac
(32)
,
D. Pop
,
J Mouroux
,
Ion Donici
,
M. Prudhomme
,
E. Felli
,
Stéphanie Lisunfui
,
Marie Seman
,
Gaelle Godiris Petit
,
M Karoui
,
Christophe Tresallet
(11)
1
JPArc -
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837
2 Service d'Hématologie [CHU Huriez Lille]
3 Université Lille Nord de France (COMUE)
4 SIRIC-ONCOLille - Site de Recherche Intégrée en Cancérologie
5 Service de Biostatistiques [CHRU Lille]
6 Département de chirurgie digestive
7 CHU - BREST - Hôpital de la Cavale Blanche - CHRU Brest
8 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
9 CHU Saint-Antoine [AP-HP]
10 Hôpital de Hautepierre [Strasbourg]
11 CHU Pitié-Salpêtrière [AP-HP]
12 Hôpital Edouard Herriot [CHU - HCL]
13 Hôpital Louis Mourier - AP-HP [Colombes]
14 CHUV - Centre Hospitalier Universitaire Vaudois [Lausanne]
15 ULB - Hôpital Erasme [Bruxelles]
16 CHU Pontchaillou [Rennes]
17 Hôpital Haut-Lévêque
18 CIC-IT Bordeaux
19 Hôpital Haut-Lévêque [CHU Bordeaux]
20 Service de chirurgie générale et viscérale
21 Département de chirurgie digestive
22 Service Chirurgie Digestive
23 Service de Chirurgie Générale et Digestive[Lille]
24 Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges]
25 HCP - Homéostasie Cellulaire et Pathologies
26 Hôpital de la Croix-Rousse [CHU - HCL]
27 Alimentary Tract Surgery
28 EA3738 - Ciblage thérapeutique en Oncologie
29 ICGM ICMMM - Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier
30 Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
31 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
32 Department of Thoracic Surgery
2 Service d'Hématologie [CHU Huriez Lille]
3 Université Lille Nord de France (COMUE)
4 SIRIC-ONCOLille - Site de Recherche Intégrée en Cancérologie
5 Service de Biostatistiques [CHRU Lille]
6 Département de chirurgie digestive
7 CHU - BREST - Hôpital de la Cavale Blanche - CHRU Brest
8 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
9 CHU Saint-Antoine [AP-HP]
10 Hôpital de Hautepierre [Strasbourg]
11 CHU Pitié-Salpêtrière [AP-HP]
12 Hôpital Edouard Herriot [CHU - HCL]
13 Hôpital Louis Mourier - AP-HP [Colombes]
14 CHUV - Centre Hospitalier Universitaire Vaudois [Lausanne]
15 ULB - Hôpital Erasme [Bruxelles]
16 CHU Pontchaillou [Rennes]
17 Hôpital Haut-Lévêque
18 CIC-IT Bordeaux
19 Hôpital Haut-Lévêque [CHU Bordeaux]
20 Service de chirurgie générale et viscérale
21 Département de chirurgie digestive
22 Service Chirurgie Digestive
23 Service de Chirurgie Générale et Digestive[Lille]
24 Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges]
25 HCP - Homéostasie Cellulaire et Pathologies
26 Hôpital de la Croix-Rousse [CHU - HCL]
27 Alimentary Tract Surgery
28 EA3738 - Ciblage thérapeutique en Oncologie
29 ICGM ICMMM - Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier
30 Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
31 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
32 Department of Thoracic Surgery
Nicolas Carrère
- Function : Author
- PersonId : 907736
- ORCID : 0000-0001-8816-6109
Jérémie Lefevre
- Function : Author
- PersonId : 761123
- ORCID : 0000-0001-7601-7464
- IdRef : 069781664
G. Luc
- Function : Author
Patrick Lozach
- Function : Author
Serge Cappeliez
- Function : Author
G. Lebreton
- Function : Author
A. Alves
- Function : Author
Federica Pipitone
- Function : Author
Nicolas Contival
- Function : Author
Eric Pappalardo
- Function : Author
Styliani Mantziari
- Function : Author
F. Hec
- Function : Author
Marguerite Vanderbeken
- Function : Author
Williams Tessier
- Function : Author
F Fredon
- Function : Author
Alain Gainant
- Function : Author
- PersonId : 1004833
Jm Bigourdan
- Function : Author
Salim Mezoughi
- Function : Author
Jacques Baulieux
- Function : Author
Oussama Baraket
- Function : Author
Delphine Vaudoyer
- Function : Author
J Enfer
- Function : Author
L Villeneuve
- Function : Author
T Coste
- Function : Author
F Marchal
- Function : Author
Romain Frisoni
- Function : Author
Ahmet Ayav
- Function : Author
- PersonId : 762396
- IdRef : 09518399X
Laurent Brunaud
- Function : Author
- PersonId : 763152
- ORCID : 0000-0001-5182-6660
- IdRef : 076629260
C Cohen
- Function : Author
Olivier Aze
- Function : Author
D. Pop
- Function : Author
J Mouroux
- Function : Author
Ion Donici
- Function : Author
M. Prudhomme
- Function : Author
E. Felli
- Function : Author
Stéphanie Lisunfui
- Function : Author
Marie Seman
- Function : Author
Gaelle Godiris Petit
- Function : Author
M Karoui
- Function : Author
Abstract
Objectives: To assess the impact of neoadjuvant chemoradiotherapy (NCRT) on anastomotic leakage (AL) and other postoperative outcomes after esophageal cancer (EC) resection.
Background: Conflicting data have emerged from randomized studies regarding the impact of NCRT on AL.
Methods: Among 2944 consecutive patients operated on for EC between 2000 and 2010 in 30 European centers, patients treated by NCRT after surgery (n = 593) were compared with those treated by primary surgery (n = 1487). Multivariable analyses and propensity score matching were used to compensate for the differences in some baseline characteristics.
Results: Patients in the NCRT group were younger, with a higher prevalence of male sex, malnutrition, advanced tumor stage, squamous cell carcinoma, and surgery after 2005 when compared with the primary surgery group. Postoperative AL rates were 8.8% versus 10.6% (P = 0.220), and 90-day postoperative mortality and morbidity rates were 9.3% versus 7.2% (P = 0.110) and 33.4% versus 32.1% (P = 0.564), respectively. Pulmonary complication rates did not differ between groups (24.6% vs 22.5%; P = 0.291), whereas chylothorax (2.5% vs 1.2%; P = 0.020), cardiovascular complications (8.6% vs 0.1%; P = 0.037), and thromboembolic events (8.6% vs 6.0%; P = 0.037) were higher in the NCRT group. After propensity score matching, AL rates were 8.8% versus 11.3% (P = 0.228), with more chylothorax (2.5% vs 0.7%; P = 0.030) and trend toward more cardiovascular and thromboembolic events in the NCRT group (P = 0.069). Predictors of AL were high American Society of Anesthesiologists scores, supracarinal tumoral location, and cervical anastomosis, but not NCRT.
Conclusions: Neoadjuvant chemoradiotherapy does not have an impact on the AL rate after EC resection (NCT 01927016).