Docetaxel-Based Neoadjuvant Chemotherapy Followed by En Bloc Resection for Esophageal Adenocarcinoma: A 15-Year Retrospective Analysis from a Regional Upper Gastrointestinal Cancer Network

Backround Real-world, long-term survival outcomes of neoadjuvant, docetaxel-based therapy for esophageal and junctional adenocarcinoma are lacking. This study describes the long-term survival outcomes of patients with esophageal and junctional adenocarcinoma treated with neoadjuvant docetaxel-based...

Full description

Saved in:
Bibliographic Details
Published in:Annals of surgical oncology 2024-04, Vol.31 (4), p.2461-2469
Main Authors: Tankel, James, Ahmed, Nabeel, Mueller, Carmen, Najmeh, Sarah, Spicer, Jonathan, Mulder, David, Cool-Lartigue, Jonathan, Rousseau, Mathieu, Frechette, Dominique, Sud, Shelly, Kavan, Petr, Moghrabi, Albert, Champagne, Martin, Lemay, Frederic, Dalfen, Richard, Sirhan, Shireen, Asselah, Jamil, Alcindor, Thierry, Ferri, Lorenzo
Format: Article
Language:English
Subjects:
Adenocarcinoma
Cancer
Chemotherapy
Cisplatin
Esophageal cancer
Esophagus
Gastrointestinal cancer
Lymph nodes
Medicine
Medicine & Public Health
Oncology
Oxaliplatin
Surgery
Surgical Oncology
Thoracic Oncology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Backround Real-world, long-term survival outcomes of neoadjuvant, docetaxel-based therapy for esophageal and junctional adenocarcinoma are lacking. This study describes the long-term survival outcomes of patients with esophageal and junctional adenocarcinoma treated with neoadjuvant docetaxel-based chemotherapy and en bloc transthoracic esophagectomy. Methods A retrospective cohort analysis of a prospectively maintained database from a regional upper gastrointestinal cancer network in Quebec, Canada, was performed. From January 2007 to December 2021, all patients with locally advanced (cT3 and/or N1) esophageal/Siewert I/II adenocarcinoma treated with neoadjuvant DCFx3 (Docetaxel/Cisplatin/5FU) or FLOTx4 (5FU/Leucovorin/Oxaliplatin/Docetaxel) and transthoracic en bloc esophagectomy were identified. Postoperative, pathological, and survival outcomes were compared. Results Overall, 236 of 420 patients met the inclusion criteria. Tumor location was esophageal/Siewert I/Siewert II (118/33/85), most were cT3-4 (93.6%) and cN+ (61.0%). DCF and FLOT were used in 127 of 236 (53.8%) and 109 of 236 (46.2%). All neoadjuvant cycles were completed in 87.3% with no difference between the regimens. Operative procedures included Ivor Lewis (81.8%), left thoraco-abdominal esophagectomy (10.6%) and McKeown (7.6%) with an R0 resection in 95.3% and pathological complete response in 9.7% (DCF 12.6%/FLOT 6.4%, p = 0.111). The median lymph node yield was 32 (range 4–79), and 60.6% were ypN+. Median follow-up was longer for the DCF group (74.8 months 95% confidence interval [CI] 4–173 vs. 37.8 months 95% CI 2–119, p
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-023-14779-4