Abstract
Background: It remains unclear if patients with clinical stage T2 N0 (cT2 N0) esophageal cancer should be offered induction therapy vs surgical intervention alone. Methods: This was a retrospective cohort study of cT2 N0 patients undergoing induction therapy, followed by surgical resection, or resection alone, at the Johns Hopkins Hospital from 1989 to 2009. Kaplan-Meier analysis was used to compare all-cause mortality in cT2 N0 patients who had resection alone vs those who had induction chemoradiation therapy, followed by resection. Results: A study cohort of 69 patients was identified and divided into two groups: 55 patients (79.7%) received induction therapy and 14 (20.3%) did not. No statistically significant difference in 5-year survival rate was observed for the two groups: 49.5% for the resection-only group and 53.8% for the induction group. More than 50% of cT2 N0 patients were understaged. Conclusions: For cT2 N0 esophageal cancer patients, the benefit of neoadjuvant therapy is still unclear. Induction therapy for cT2 N0 did not translate into a statistically significant improvement in survival. However, due to the significant understaging of T2 N0 patients, we recommend neoadjuvant therapy to all cT2N0 patients before operation.
Original language | English (US) |
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Pages (from-to) | 429-437 |
Number of pages | 9 |
Journal | Annals of Thoracic Surgery |
Volume | 93 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2012 |
Keywords
- ASA
- American Society of Anesthesiologists
- CI
- CT
- EUS
- HR
- IQR
- PET
- R0
- R1
- cT2 N0
- clinical stage T2 N0
- computed tomography
- confidence interval
- endoscopic ultrasound
- hazard ratio
- interquartile range
- margin negative
- margin positive
- pT2 N0
- pathologic stage T2 N0
- positron emission tomography
ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine