Adjuvant Therapy After Neoadjuvant Therapy for Esophageal Cancer

医学 辅助治疗 新辅助治疗 佐剂 食管癌 肿瘤科 内科学 腺癌 癌症 乳腺癌
作者
Siva Raja,Thomas W. Rice,Min Lü,Marie E. Semple,Eugene H. Blackstone,Sudish C. Murthy,Usman Ahmad,Michael McNamara,Andrew Toth,Hemant Ishwaran
出处
期刊:Annals of Surgery [Lippincott Williams & Wilkins]
卷期号:278 (2): e240-e249 被引量:14
标识
DOI:10.1097/sla.0000000000005679
摘要

Objective: We hypothesized that, on average, patients do not benefit from additional adjuvant therapy after neoadjuvant therapy for locally advanced esophageal cancer, although subsets of patients might. Therefore, we sought to identify profiles of patients predicted to receive the most survival benefit or greatest detriment from adding adjuvant therapy. Background: Although neoadjuvant therapy has become the treatment of choice for locally advanced esophageal cancer, the value of adding adjuvant therapy is unknown. Methods: From 1970 to 2014, 22,123 patients were treated for esophageal cancer at 33 centers on 6 continents (Worldwide Esophageal Cancer Collaboration), of whom 7731 with adenocarcinoma or squamous cell carcinoma received neoadjuvant therapy; 1348 received additional adjuvant therapy. Random forests for survival and virtual-twin analyses were performed for all-cause mortality. Results: Patients received a small survival benefit from adjuvant therapy (3.2±10 months over the subsequent 10 years for adenocarcinoma, 1.8±11 for squamous cell carcinoma). Consistent benefit occurred in ypT3–4 patients without nodal involvement and those with ypN2–3 disease. The small subset of patients receiving most benefit had high nodal burden, ypT4, and positive margins. Patients with ypT1–2N0 cancers had either no benefit or a detriment in survival. Conclusions: Adjuvant therapy after neoadjuvant therapy has value primarily for patients with more advanced esophageal cancer. Because the benefit is often small, patients considering adjuvant therapy should be counseled on benefits versus morbidity. In addition, given that the overall benefit was meaningful in a small number of patients, emerging modalities such as immunotherapy may hold more promise in the adjuvant setting.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
yuchangkun发布了新的文献求助10
1秒前
科研通AI5应助落寞黎昕采纳,获得10
2秒前
2秒前
甜美迎南完成签到 ,获得积分10
2秒前
肖福艳完成签到,获得积分10
3秒前
zky给zky的求助进行了留言
3秒前
Can完成签到,获得积分10
3秒前
sunglow11完成签到,获得积分0
4秒前
三三完成签到,获得积分10
6秒前
wowser完成签到,获得积分10
6秒前
DaSheng发布了新的文献求助10
7秒前
顾矜应助岳梦林采纳,获得10
7秒前
学术小垃圾完成签到,获得积分10
8秒前
Owen应助yuchangkun采纳,获得10
9秒前
草莓派完成签到,获得积分10
9秒前
繁荣的青旋完成签到 ,获得积分10
10秒前
LC完成签到,获得积分10
10秒前
开始游戏55完成签到,获得积分10
10秒前
充电宝应助傲娇衬衫采纳,获得10
10秒前
巫马炎彬完成签到,获得积分10
11秒前
wowser发布了新的文献求助10
12秒前
Jasmineyfz完成签到 ,获得积分10
12秒前
13秒前
14秒前
14秒前
李爱国应助山猪吃细糠采纳,获得10
15秒前
17秒前
理理完成签到 ,获得积分10
17秒前
19秒前
Nobody发布了新的文献求助10
19秒前
淀粉肠完成签到 ,获得积分10
19秒前
苹果巧蕊完成签到 ,获得积分10
20秒前
李西瓜完成签到 ,获得积分10
21秒前
欧欧欧导完成签到,获得积分10
21秒前
义气的钥匙发布了新的文献求助100
22秒前
Anyixx发布了新的文献求助10
23秒前
辣椒完成签到,获得积分10
23秒前
11发布了新的文献求助10
23秒前
23秒前
隐形曼青应助chen采纳,获得10
24秒前
高分求助中
【此为提示信息,请勿应助】请按要求发布求助,避免被关 20000
Les Mantodea de Guyane Insecta, Polyneoptera 2500
Technologies supporting mass customization of apparel: A pilot project 450
Brain and Heart The Triumphs and Struggles of a Pediatric Neurosurgeon 400
Cybersecurity Blueprint – Transitioning to Tech 400
Mixing the elements of mass customisation 400
Периодизация спортивной тренировки. Общая теория и её практическое применение 310
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 物理 生物化学 纳米技术 计算机科学 化学工程 内科学 复合材料 物理化学 电极 遗传学 量子力学 基因 冶金 催化作用
热门帖子
关注 科研通微信公众号,转发送积分 3782905
求助须知:如何正确求助?哪些是违规求助? 3328212
关于积分的说明 10235338
捐赠科研通 3043308
什么是DOI,文献DOI怎么找? 1670468
邀请新用户注册赠送积分活动 799719
科研通“疑难数据库(出版商)”最低求助积分说明 759033