Esophageal Adenocarcinoma Methods and Protocols

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Table 1 Landmark studies of chemotherapy in the curative settingAuthor


Experimental arm

Control arm

Outcomes

% of esophageal/esophagogastric junction adenocarcinoma

Subgroup outcomes

PreoperativeIntergroup 0113

(1998, 2007) [^9

,^10

]

Preoperative

PF

×

3

Surgery

alone

No survival benefit

52.2%


  • Similar outcomes in


adenocarcinoma and squamous cell carcinoma


  • Locoregional and distant failure


were higher in adenocarcinoma in the surgery alone arm


  • Decreased risk of death for


adenocarcinoma in the preop PF arm.

MRC OE02

(2002, 2009) [^11

,^12

]

Preoperative

PF

×

2

Surgery

alone

Improved OS (HR 0.79,

p^

=^

0.004)

mOS: 16.8

months vs.

13.3

months

66%


  • Similar outcomes in


adenocarcinoma and squamous cell carcinoma

PerioperativeMRC MAGIC

(2006) [

16

]

Perioperative

ECF

Surgery

alone

Improved OS (HR 0.75,

p^

=^

0.009) and PFS
(HR 0.66,

p^

<^

0.001)

5 year OS 36% vs. 23%

26%(lower esophagus: 14.5%GEJ:11.5%)


  • Similar outcomes in gastric,


esophagus or: esophagogastric junction tumors

FNCLCC/FFCD

(2011) [

17

]

Perioperative

PF

Surgery

alone

Improved OS (HR 069,

p^

=^

0.02) and DFS
(HR 0.65,

p^

=^

0.003)

5

year OS 38% vs. 24%
5

year DFS 34% vs. 19%

75%


  • Tumor location was a significant


prognostic factor in multivariable analysis (

p^

<^

0.01)

(continued)

Chemotherapy
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