This randomized trial involving 30 centers in France compared outcomes after induction chemoradiotherapy followed by resection to resection alone for stage I or II esophageal cancer. The R0 resection rate was similar between the groups. Postoperative mortality was higher in the induction therapy group (11.1% vs 3.4%). Long-term survival was simila
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Esophagus
July 29, 2014
Using data from 2 centers in London, outcomes after induction therapy and resection for esophageal cancer were analyzed according to the pathological response to induction therapy. Downstaging was the strongest predictor of survival (HR 0.43). Downstaging was also associated with a lower rate of local recurrence (6% vs 13%) and systemic recurrence
July 28, 2014
The authors queried whether PET has utility in clinically staging Tis or T1 esophageal cancers; this was a single institution retrospective study involving 79 pts. The incidence of FDG uptake increased with increasing T status, as did the SUV. Nodal staging was false positive in 3 pts and false negative all 13 pts with nodal involvement. Metastati
July 28, 2014
The efficacy of induction therapy for clinical T2 esophageal cancer was evaluated using the National Cancer Database. Pretreatment staging was accurate in only 27% of pts. 42% of pts were upstaged and 32% were downstaged. Induction therapy had no survival benefit.
July 28, 2014
This study tracked changes in management for and outcomes of T1a and T1b esophageal cancer using data from the National Cancer Data Base. Endoscopic resection increased nearly 3-fold to 53% for T1a lesions during the interval, and increased nearly 3-fold to 21% for T1b cancers. Nodal involvement was predicted by T status, tumor size >2cm, and tu
July 12, 2014
Volume-outcomes relationships for operative mortality were first identified more than a decade ago. This study updated the data using Medicare claims for more than 3 million patients. The inverse relationship between volume and outcomes was confirmed for all 8 procedures studied. The inverse ratio actually increased for 5 of 8 procedures despite o
July 12, 2014
This single institution study evaluated differences in 30-day and 90-day mortality after esophagectomy in nearly 1300 patients. 30-day mortality was 2.9%, hospital mortalit was 5.1%, and 90-day mortality was 7%. Late deaths were related to surgery (particularly the occurrence of anastomotic leakage), sudden death, and recurrent cancer. The sensiti
July 12, 2014
A risk model of mortality associated with esophagectomy in Japan was developed using variables identified in the ACS NSQIP program. 30-day and overall surgical mortality rates were 1.2% and 3.4%, and the morbidity rate was 42%. Morbidity was higher after minimally invasive esophagectomy. Mortality was related to difficulty with ADLs, recent smokin
July 12, 2014
This editorial, authored by a number of presidents/leaders of prominent medical societies, laments a recent position paper of the ESMO espousing medical oncologists as the natural team leaders of multidisciplinary oncologic care. It cautions other cancer specialists not to abandon their roles as advocates for their cancer patients.
July 1, 2014
In this randomized trial involving195 pts from 30 centers, pts underwent chemoradiotherapy followed by surgery or surgery alone for stage I or II esophageal cancer. The median follow-up was 94 months. 80% of pts had clinical stage II disease. R0 resection rate and 3-year survival were similar between the groups. Induction therapy was associated w