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Article: The Effects of Neoadjuvant Chemoradiation on pTNM Staging and Its Prognostic Significance in Esophageal Cancer

TitleThe Effects of Neoadjuvant Chemoradiation on pTNM Staging and Its Prognostic Significance in Esophageal Cancer
Authors
Keywordschemoradiation
Esophageal neoplasm
multimodality treatment
prognosis
staging
Issue Date2006
PublisherSpringer New York LLC.
Citation
Journal Of Gastrointestinal Surgery, 2006, v. 10 n. 9, p. 1301-1311 How to Cite?
AbstractFor esophageal cancer, it is not clear if pathologic TNM staging after chemoradiation and resection will have the same prognostic significance compared with patients who undergo resection only. From 1995 to 2004, prospectively collected data from 279 patients with intrathoracic squamous cell cancers were analyzed. Patients were given chemoradiation either as part of a randomized trial comparing neoadjuvant chemoradiation with surgical resection alone, or because of advanced disease at presentation. One hundred seventy patients had surgical resection only (surgery), and 109 had neoadjuvant chemoradiation (CRT plus surgery). In the surgery group, pT1, 2, 3, and 4 disease was found in 15, 17, 104, and 34 patients, respectively; their respective pN1 rates were 13.3%, 29.4%, 57.7%, and 64.7%, P < 0.01. In CRT plus surgery, pT0, T1, 2, 3, and 4 were found in 48, 12, 23, 21, and 5 patients, respectively; their respective pN1 rates were 31.3%, 16.7%, 21.7%, 52.4%, and 20%, P = 0.44. Logistic regression analysis of factors predictive of pN1 showed that pT stage correlated with pN1 status (P = 0.005) in the surgery group, but not for the CRT plus surgery group. Cox regression analysis demonstrated that in the surgery group, pT, pN, and R category, and overall pTNM stage, were independent prognostic factors, whereas pN, R category, and gender were identified as relevant for CRT plus surgery. After chemoradiation, pT and overall pTNM stage groupings were not as clearly prognostic as in patients without prior therapy. Nodal status remains an important prognostic factor. © 2006 The Society for Surgery of the Alimentary Tract.
Persistent Identifierhttp://hdl.handle.net/10722/72038
ISSN
2015 Impact Factor: 2.807
2015 SCImago Journal Rankings: 1.640
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorWong, KHen_HK
dc.contributor.authorKwok, KFen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T06:37:44Z-
dc.date.available2010-09-06T06:37:44Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Gastrointestinal Surgery, 2006, v. 10 n. 9, p. 1301-1311en_HK
dc.identifier.issn1091-255Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/72038-
dc.description.abstractFor esophageal cancer, it is not clear if pathologic TNM staging after chemoradiation and resection will have the same prognostic significance compared with patients who undergo resection only. From 1995 to 2004, prospectively collected data from 279 patients with intrathoracic squamous cell cancers were analyzed. Patients were given chemoradiation either as part of a randomized trial comparing neoadjuvant chemoradiation with surgical resection alone, or because of advanced disease at presentation. One hundred seventy patients had surgical resection only (surgery), and 109 had neoadjuvant chemoradiation (CRT plus surgery). In the surgery group, pT1, 2, 3, and 4 disease was found in 15, 17, 104, and 34 patients, respectively; their respective pN1 rates were 13.3%, 29.4%, 57.7%, and 64.7%, P < 0.01. In CRT plus surgery, pT0, T1, 2, 3, and 4 were found in 48, 12, 23, 21, and 5 patients, respectively; their respective pN1 rates were 31.3%, 16.7%, 21.7%, 52.4%, and 20%, P = 0.44. Logistic regression analysis of factors predictive of pN1 showed that pT stage correlated with pN1 status (P = 0.005) in the surgery group, but not for the CRT plus surgery group. Cox regression analysis demonstrated that in the surgery group, pT, pN, and R category, and overall pTNM stage, were independent prognostic factors, whereas pN, R category, and gender were identified as relevant for CRT plus surgery. After chemoradiation, pT and overall pTNM stage groupings were not as clearly prognostic as in patients without prior therapy. Nodal status remains an important prognostic factor. © 2006 The Society for Surgery of the Alimentary Tract.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC.en_HK
dc.relation.ispartofJournal of Gastrointestinal Surgeryen_HK
dc.subjectchemoradiationen_HK
dc.subjectEsophageal neoplasmen_HK
dc.subjectmultimodality treatmenten_HK
dc.subjectprognosisen_HK
dc.subjectstagingen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - therapeutic useen_HK
dc.subject.meshCarcinoma, Squamous Cell - diagnosis - pathology - therapyen_HK
dc.subject.meshDose Fractionationen_HK
dc.subject.meshEsophageal Neoplasms - diagnosis - pathology - therapyen_HK
dc.subject.meshEsophagectomyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNeoadjuvant Therapyen_HK
dc.subject.meshNeoplasm Stagingen_HK
dc.subject.meshPrognosisen_HK
dc.titleThe Effects of Neoadjuvant Chemoradiation on pTNM Staging and Its Prognostic Significance in Esophageal Canceren_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1091-255X&volume=10&issue=9&spage=1301&epage=1311&date=2006&atitle=The+effects+of+neoadjuvant+chemoradiation+on+pTNM+staging+and+its+prognostic+significance+in+esophageal+canceren_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.gassur.2006.06.009en_HK
dc.identifier.pmid17114016-
dc.identifier.scopuseid_2-s2.0-33751233550en_HK
dc.identifier.hkuros127254en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33751233550&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume10en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1301en_HK
dc.identifier.epage1311en_HK
dc.identifier.isiWOS:000242649700019-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridWong, KH=36485841700en_HK
dc.identifier.scopusauthoridKwok, KF=7102194177en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.citeulike10439732-

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