Title :

Discrepancy between clinical and pathologic nodal status of esophageal cancer and impact on prognosis and therapeutic strategy

Author(s) :

Markar, Sheraz R. [Auteur]
Imperial College London
Gronnier, Caroline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Pasquer, Arnaud [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Behal, Helene [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Thereaux, Jeremie [Auteur]
Centre Hospitalier Régional Universitaire de Brest [CHRU Brest]
Gagniere, Johan [Auteur]
CHU Clermont-Ferrand
Lebreton, Gil [Auteur]
CHU Caen
Brigand, Cécile [Auteur]
Hôpital de Hautepierre [Strasbourg]
Renaud, Florence [Auteur]

Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc) - U1172
Piessen, Guillaume [Auteur]

Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc) - U1172
Meunier, Bernard [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Collet, Denis [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Mariette, Christophe [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]

Journal title :

Annals of surgical oncology

Abbreviated title :

Ann. Surg. Oncol.

Volume number :

24

Pages :

3911-3920

Publication date :

2017-12-01

ISSN :

1068-9265

English keyword(s) :

Mesh:Neoplasm Staging
Mesh:Adenocarcinoma/surgery
Mesh:Esophageal Neoplasms/pathology*
Mesh:Survival Rate
Mesh:Esophageal Neoplasms/surgery
Mesh:Male
Mesh:Female
Mesh:Middle Aged
Mesh:Follow-Up Studies
Mesh:Humans
Mesh:Lymph Nodes/pathology*
Mesh:Lymph Nodes/surgery
Mesh:Risk Factors
Mesh:Retrospective Studies
Mesh:Adenocarcinoma/pathology*

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: The impact of discrepancies between clinical (c) and pathologic (p) stages of esophageal cancer remains a poorly understood issue. This study aimed to compare the prognosis of patient groups treated by primary ...
Show more >BACKGROUND: The impact of discrepancies between clinical (c) and pathologic (p) stages of esophageal cancer remains a poorly understood issue. This study aimed to compare the prognosis of patient groups treated by primary surgery including clinical N0/pathologic N0 (cN0pN0), clinical N0/pathologic N+ (cN0pN+), clinical N+/pathologic N0 (cN+pN0), and clinical N+/pathologic N+ (cN+pN+). METHODS: Data were collected from 30 European centers during the years 2000 to 2010. Among 2944 recruited patients, 1554 patients receiving primary surgery met the inclusion criteria including 613 cN0pN0, 403 cN0pN+, 220 cN+pN0, and 318 cN+pN+ patients. Analyses with adjustment of the propensity score were used to compensate for differences in baseline characteristics. RESULTS: Clinical T stages 3 and 4 were increased in cN+pN+ (73.0%), cN0pN+ (49.6%), and cN+pN0 (51.8%) compared with cN0pN0 (32.8%). Compared with cN0pN0, cN+pN+ and cN0pN+ showed an increase in the proportion of adenocarcinoma histologic subtype, poor tumor differentiation, pathologic T3 and T4 stages, and R1/2 resection margin. Adjusted 5-year overall survival (hazard ratio [HR] 3.12; 95% confidence interval [CI] 2.57-3.78; P < 0.001) and event-free survival (HR 2.87; 95% CI 2.39-3.45; P < 0.001) were significantly reduced in cN0pN+ compared with cN0pN0. No significant differences in 5-year overall survival or event-free survival between cN0pN+ and cN+pN+ were observed. Regression analysis identified an association of distal tumor location, advanced clinical T stage, and poor tumor differentiation with pN+ disease. CONCLUSIONS: This large multicenter study showed that cN0pN+ has a prognosis similar to that of cN+pN+ and worse than that of cN0pN0. Patients with clinical N0 disease but risk factors for pathologic N+ disease may benefit from neoadjuvant therapy before surgery.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:55:20Z
2020-04-06T08:40:46Z