학술논문
Postoperative and Pathological Outcomes of CROSS and FLOT as Neoadjuvant Therapy for Esophageal and Junctional Adenocarcinoma: An International Cohort Study From the Oesophagogastric Anastomosis Audit (OGAA)
Document Type
Academic Journal
Author
Steering Committee; Alderson, D; Bundred, J; RPT, Evans; Gossage, J; Griffiths, EA; Jefferies, B; Kamarajah, SK; McKay, S; Mohamed, I; Nepogodiev, D; Siaw- Acheampong, K; Singh, P; van Hillegersberg, R; Vohra, R; Wanigasooriya, K; Whitehouse, T.; National Leads; Gjata, A; Moreno, JI; Takeda, FR; Kidane, B; Guevara Castro, R; Harustiak, T; Bekele, A; Kechagias, A; Gockel, I; Kennedy, A; Da Roit, A; Bagajevas, A; Azagra, JS; Mahendran, HA; Mejía-Fernández, L; Wijnhoven, BPL; El Kafsi, J; Sayyed, RH; Sousa, M; Sampaio, AS; Negoi, I; Blanco, R; Wallner, B; Schneider, PM; Hsu, PK; Isik, A; Site Leads; Gananadha, S; Wills, V; Devadas, M; Duong, C; Talbot, M; Hii, MW; Jacobs, R; Andreollo, NA; Johnston, B; Darling, G; Isaza-Restrepo, A; Rosero, G; Arias- Amézquita, F; Raptis, D; Gaedcke, J; Reim, D; Izbicki, J; Egberts, JH; Dikinis, S; Kjaer, DW; Larsen, MH; Achiam, MP; Saarnio, J; Theodorou, D; Liakakos, T; Korkolis, DP; Robb, WB; Collins, C; Murphy, T; Reynolds, J; Tonini, V; Migliore, M; Bonavina, L; Valmasoni, M; Bardini, R; Weindelmayer, J; Terashima, M; White, RE; Alghunaim, E; Elhadi, M; Leon-Takahashi, AM; Medina-Franco, H; Lau, PC; Okonta, KE; Heisterkamp, J; Rosman, C; van Hillegersberg, R; Beban, G; Babor, R; Gordon, A; Rossaak, JI; Pal, KMI; Qureshi, AU; Naqi, SA; Syed, AA; Barbosa, J; Vicente, CS; Leite, J; Freire, J; Casaca, R; Costa, RCT; Scurtu, RR; Mogoanta, SS; Bolca, C; Constantinoiu, S; Sekhniaidze, D; Bjelović, M; So, JBY; Gačevski, G; Loureiro, C; Pera, M; Bianchi, A; Moreno Gijón, M; Martín Fernández, J; Trugeda Carrera, MS; Vallve-Bernal, M; Cítores Pascual, MA; Elmahi, S; Halldestam, I; Hedberg, J; Mönig, S; Gutknecht, S; Tez, M; Guner, A; Tirnaksiz, MB; Colak, E; Sevinç, B; Hindmarsh, A; Khan, I; Khoo, D; Byrom, R; Gokhale, J; Wilkerson, P; Jain, P; Chan, D; Robertson, K; Iftikhar, S; Skipworth, R; Forshaw, M; Higgs, S; Gossage, J; Nijjar, R; Viswanath, YKS; Turner, P; Dexter, S; Boddy, A; Allum, WH; Oglesby, S; Cheong, E; Beardsmore, D; Vohra, R; Maynard, N; Berrisford, R; Mercer, S; Puig, S; Melhado, R; Kelty, C; Underwood, T; Dawas, K; Lewis, W; Al-Bahrani, A; Bryce, G; Thomas, M; Arndt, AT; Palazzo, F; Meguid, RA; Collaborators; Fergusson, J; Beenen, E; Mosse, C; Salim, J; Cheah, S; Wright, T; Cerdeira, MP; McQuillan, P; Richardson, M; Liem, H; Spillane, J; Yacob, M; Albadawi, F; Thorpe, T; Dingle, A; Cabalag, C; Loi, K; Fisher, OM; Ward, S; Read, M; Johnson, M; Bassari, R; Bui, H; Cecconello, I; RAA, Sallum; da Rocha, JRM; Lopes, LR; Tercioti, V, Jr; JDS, Coelho; Ferrer, JAP; Buduhan, G; Tan, L; Srinathan, S; Shea, P; Yeung, J; Allison, F; Carroll, P; Vargas-Barato, F; Gonzalez, F; Ortega, J; Nino-Torres, L; Beltrán-García, TC; Castilla, L; Pineda, M; Bastidas, A; Gómez-Mayorga, J; Cortés, N; Cetares, C; Caceres, S; Duarte, S; Pazdro, A; Snajdauf, M; Faltova, H; Sevcikova, M; Mortensen, PB; Katballe, N; Ingemann, T; Kruhlikava, Morten B, I; Ainswort, AP; Stilling, NM; Eckardt, J; Holm, J; Thorsteinsson, M; Siemsen, M; Brandt, B; Nega, B; Teferra, E; Tizazu, A; Kauppila, JH; Koivukangas, V; Meriläinen, S; Gruetzmann, R; Krautz, C; Weber, G; Golcher, H; Emons, G; Azizian, A; Ebeling, M; Niebisch, S; Kreuser, N; Albanese, G; Hesse, J; Volovnik, L; Boecher, U; Reeh, M; Triantafyllou, S; Schizas, D; Michalinos, A; Balli, E; Mpoura, M; Charalabopoulos, A; Manatakis, DK; Balalis, D; Bolger, J; Baban, C; Mastrosimone, A; McAnena, O; Quinn, A; Ó Súilleabháin, CB; Hennessy, MM; Ivanovski, I; Khizer, H; Ravi, N; Donlon, N; Cervellera, M; Vaccari, S; Bianchini, S; Sartarelli, l; Asti, E; Bernardi, D; Merigliano, S; Provenzano, L; Scarpa, M; Saadeh, L; Salmaso, B; De Manzoni, G; Giacopuzzi, S; La Mendola; R; De Pasqual, CA; Tsubosa, Y; Niihara, M; Irino, T; Makuuchi, R; Ishii, K; Mwachiro, M; Fekadu, A; Odera, A; Mwachiro, E; AlShehab, D; Ahmed, HA; Shebani, AO; Elhadi, A; Elnagar, FA; Elnagar, HF; Makkai-Popa, ST; Wong, LF; Tan, YR; Thannimalai, S; Ho, CA; Pang, WS; Tan, JH; HNL, Basave; Cortés-González, R; Lagarde, SM; van Lanschot, JJB; Cords, C; Jansen, WA; Martijnse, I; Matthijsen, R; Bouwense, S; Klarenbeek, B; Verstegen, M; van Workum, F; Ruurda, JP; van der Sluis, PC; de Maat, M; Evenett, N; Johnston, P; Patel, R; MacCormick, A; Young, M; Smith, B; Ekwunife, C; Memon, AH; Shaikh, K; Wajid, A; Khalil, N; Haris, M; Mirza, ZU; SBA, Qudus; Sarwar, MZ; Shehzadi, A; Raza, A; Jhanzaib, MH; Farmanali, J; Zakir, Z; Shakeel, O; Nasir, I; Khattak, S; Baig, M; Noor, MA; Ahmed, HH; Naeem, A; Pinho, AC; da Silva, R; Bernardes, A; Campos, JC; Matos, H; Braga, T; Monteiro, C; Ramos, P; Cabral, F; Gomes, MP; Martins, PC; Correia, AM; Videira, JF; Ciuce, C; Drasovean, R; Apostu, R; Ciuce, C; Paitici, S; Racu, AE; Obleaga, CV; Beuran, M; Stoica, B; Negoita, Ciubotaru C, V; Cordos, I; Birla, RD; Predescu, D; Hoara, PA; Tomsa, R; Shneider, V; Agasiev, M; Ganjara, I; Gunjić, D; Veselinović, M; Babič, T; Chin, TS; Shabbir, A; Kim, G; Crnjac, A; Samo, H; Díez del Val, I; Leturio, S; Ramón, JM; Dal Cero, M; Rifá, S; Rico, M; Pagan Pomar, A; Martinez Corcoles, JA; Rodicio Miravalles, JL; Pais, SA; Turienzo, SA; Alvarez, LS; Campos, PV; Rendo, AG; García, SS; EPG, Santos; Martínez, ET; Fernández Díaz, MJ; Magadán Álvarez, C; Concepción Martín, V; Díaz López, C; Rosat Rodrigo, A; Pérez Sánchez, LE; Bailón Cuadrado, M; Tinoco Carrasco, C; Choolani Bhojwani, E; Sánchez, DP; Ahmed, ME; Dzhendov, T; Lindberg, F; Rutegård, M; Sundbom, M; Mickael, C; Colucci, N; Schnider, A; Er, S; Kurnaz, E; Turkyilmaz, S; Turkyilmaz, A; Yildirim, R; Baki, BE; Akkapulu, N; Karahan, O; Damburaci, N; Hardwick, R; Safranek, P; Sujendran, V; Bennett, J; Afzal, Z; Shrotri, M; Chan, B; Exarchou, K; Gilbert, T; Amalesh, T; Mukherjee, D; Mukherjee, S; Wiggins, TH; Kennedy, R; McCain, S; Harris, A; Dobson, G; Davies, N; Wilson, I; Mayo, D; Bennett, D; Young, R; Manby, P; Blencowe, N; Schiller, M; Byrne, B; Mitton, D; Wong, V; Elshaer, A; Cowen, M; Menon, V; Tan, LC; McLaughlin, E; Koshy, R; Sharp, C; Brewer, H; Das, N; Cox, M; Al Khyatt, W; Worku, D; Iqbal, R; Walls, L; McGregor, R; Fullarton, G; Macdonald, A; MacKay, C; Craig, C; Dwerryhouse, S; Hornby, S; Jaunoo, S; Wadley, M; Baker, C; Saad, M; Kelly, M; Davies, A; Di Maggio, F; McKay, S; Mistry, P; Singhal, R; Tucker, O; Kapoulas, S; Powell-Brett, S; Davis, P; Bromley, G; Watson, L; Verma, R; Ward, J; Shetty, V; Ball, C; Pursnani, K; Sarela, A; Sue Ling, H; Mehta, S; Hayden, J; To, N; Palser, T; Hunter, D; Supramaniam, K; Butt, Z; Ahmed, A; Kumar, S; Chaudry, A; Moussa, O; Kordzadeh, A; Lorenzi B Wilson, M; Patil, P; Noaman, I; Willem, J; Bouras, G; Evans, R; Singh, M; Warrilow, H; Ahmad, A; Tewari, N; Yanni, F; Couch, J; Theophilidou, E; Reilly, JJ; Singh, P; van Boxel, Gijs; Akbari, K; Zanotti, D; Sgromo, B; Sanders, G; Wheatley, T; Ariyarathenam, A; Reece-Smith, A; Humphreys, L; Choh, C; Carter, N; Knight, B; Pucher, P; Athanasiou, A; Mohamed, I; Tan, B; Abdulrahman, M; Vickers, J; Akhtar, K; Chaparala, R; Brown, R; Alasmar, MMA; Ackroyd, R; Patel, K; Tamhankar, A; Wyman, A; Walker, R; Grace, B; Abbassi, N; Slim, N; Ioannidi, L; Blackshaw, G; Havard, T; Escofet, X; Powell, A; Owera, A; Rashid, F; Jambulingam, P; Padickakudi, J; Ben-Younes, H; Mccormack, K; Makey, IA; Karush, MK; Seder, CW; Liptay, MJ; Chmielewski, G; Rosato, EL; Berger, AC; Zheng, R; Okolo, E; Singh, A; Scott, CD; Weyant, MJ; Mitchell, JD.
Source
Annals of Surgery. May 01, 2023 277(5):e1026-e1034
Subject
Language
English
ISSN
0003-4932
Abstract
OBJECTIVE:: This study aimed to compare the postoperative and pathological outcomes between carboplatin, paclitaxel, radiotherapy (CROSS) and 5-FU, leucovorine, oxaliplatin and docetaxel (FLOT) in esophageal adenocarcinoma (EAC) patients from an international, multicenter cohort. SUMMARY OF BACKGROUND DATA:: Ongoing debate exists around optimum approach to locally advanced EAC, with proponents for perioperative chemotherapy, such as FLOT, or multimodal therapy, in particular the CROSS regimen. METHODS:: Patients undergoing CROSS (n = 350) and FLOT (n = 368), followed by curative esophagectomy for EAC were identified from the Oesophagogastric Anastomosis Audit. RESULTS:: The 90-day mortality was higher after CROSS than FLOT (5% vs 1%, P = 0.005), even on adjusted analyses [odds ratio (OR): 3.97, confidence interval (CI)95%: 1.34–13.67]. Postoperative mortality in CROSS were related to higher pulmonary (74% vs 60%) and cardiac complications (42% vs 20%) compared to FLOT. CROSS was associated with higher pathologic complete response (pCR) rates (18% vs 10%, P = 0.004) and margin-negative resections (93% vs 76%, P < 0.001) compared with FLOT. On adjusted analyses, CROSS was associated with higher pCR rates (OR: 2.05, CI95%: 1.26-3.34) and margin-negative resections (OR: 4.55, CI95%: 2.70-7.69) compared to FLOT. CONCLUSIONS:: This study provides real-world data CROSS was associated with higher 90-day mortality than FLOT, related to cardio-pulmonary complications with CROSS. These warrant a further review into causes and mechanisms in selected patients, and at minimum suggest the need for strict radiation therapy quality assurance. Research into impact of higher pCR rates and R0 resections with CROSS compared to FLOT on long-term survival is needed.