Histopathologic Features are more Important Prognostic Factors than Primary Tumour Location in Gastro-oesophageal Adenocarcinoma Treated with Preoperative Chemoradiation and Surgery
Jazyk angličtina Země Švýcarsko Médium print-electronic
Typ dokumentu časopisecké články
Grantová podpora
Programme PRVOUK P37/06 and P37/11
Ministry of Education, Youth and Sport, Czech Republic
Project LM2010004
Ministry of Education, Youth and Sport, Czech Republic
PubMed
28550507
DOI
10.1007/s12253-017-0253-z
PII: 10.1007/s12253-017-0253-z
Knihovny.cz E-zdroje
- Klíčová slova
- Distal oesophageal cancer, Gastric cancer, Gastro-oesophageal junction cancer, Preoperative chemoradiation, Prognostic factor,
- MeSH
- adenokarcinom mortalita patologie terapie MeSH
- adjuvantní chemoradioterapie MeSH
- chirurgie trávicího traktu MeSH
- dospělí MeSH
- gastroezofageální junkce patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory jícnu mortalita patologie terapie MeSH
- nádory žaludku mortalita patologie terapie MeSH
- neoadjuvantní terapie MeSH
- přežití bez známek nemoci MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The aim of present study was to evaluate the impact of primary tumour location and other factors on the outcome of preoperative chemoradiation followed by surgery in adenocarcinomas of distal oesophagus, gastro-oesophageal junction and stomach. We retrospectively reviewed the institutional patient database. The therapeutic response was re-evaluated as a percentage of residual tumor cells in surgical resection specimens. Overall survival (OS) and disease-free survival (DFS) were assessed. The effect primary tumour location, clinical and pathological TNM stage, and histopathological factors (histological type, grade, angioinvasion, perineural invasion, tumour response) on treatment outcome were evaluated. A total of 108 patients underwent preoperative chemoradiation for adenocarcinoma of distal oesophagus, gastro-oesophageal junction or stomach. The median prescribed dose of radiation was 45 Gy. The concurrent chemotherapy consisted of 5-fluorouracil +/- cisplatin +/- taxanes. R0 resection was achieved in 80 patients (74%). The complete response was observed in 19%. The median follow-up was 50.8 months. Three-year and 5-year OS and DFS were 36.2% and 25.3%; and 28.1% and 23.7%, respectively. Pretreatment T-stage, pathological N-stage, radicality of resection, histological subtype, grade, angioinvasion and perineural invasion, were identified as statistical significant OS predictors in univariate analysis; pathological N-stage, radicality of resection and angioinvasion, in multivariate analysis. The primary tumor location did not influence the prognosis. The pathologic response to chemoradiation had borderline significance. In conclusion, no prognostic impact of primary tumour location, in contrast to other investigated factors, was evident in the present study. The most important predictors of prognosis were angioinvasion status and pN-stage.
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Int J Radiat Oncol Biol Phys. 2012 Jun 1;83(2):581-6 PubMed
Strahlenther Onkol. 2008 Nov;184(11):592-7 PubMed
Radiat Oncol. 2013 Jan 04;8:6 PubMed
N Engl J Med. 1996 Aug 15;335(7):462-7 PubMed
Gut. 2004 Jul;53(7):925-30 PubMed
J Am Coll Surg. 2015 Jul;221(1):83-90 PubMed
Cancer. 2006 Oct 1;107(7):1475-82 PubMed
BMC Cancer. 2015 Jul 21;15:532 PubMed
Am J Surg. 2003 Jun;185(6):538-43 PubMed
Curr Oncol. 2014 Jun;21(3):125-33 PubMed
Ann Oncol. 2013 May;24(5):1262-6 PubMed
Strahlenther Onkol. 2004 Nov;180(11):695-700 PubMed
J Clin Oncol. 2004 Jul 15;22(14):2774-80 PubMed
Eur J Cancer. 2011 Feb;47(3):354-60 PubMed
Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1430-6 PubMed
Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):741-7 PubMed
J Clin Oncol. 2011 May 1;29(13):1715-21 PubMed
J Gastrointest Cancer. 2013 Jun;44(2):162-9 PubMed
Lancet Oncol. 2015 Sep;16(9):1090-1098 PubMed
Int J Radiat Oncol Biol Phys. 2011 Jul 1;80(3):698-704 PubMed
J Clin Oncol. 2009 Feb 20;27(6):851-6 PubMed
J Clin Oncol. 2006 Aug 20;24(24):3953-8 PubMed
Cancer. 1994 Jun 1;73(11):2680-6 PubMed
N Engl J Med. 2001 Sep 6;345(10):725-30 PubMed
World J Gastroenterol. 2015 Apr 7;21(13):3850-9 PubMed
Ann Surg Oncol. 2001 Jul;8(6):519-24 PubMed
Radiother Oncol. 2007 Feb;82(2):132-6 PubMed
N Engl J Med. 2006 Jul 6;355(1):11-20 PubMed
Radiother Oncol. 2014 Aug;112(2):284-8 PubMed
Ann Oncol. 2014 May;25(5):1039-44 PubMed
