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Article: The Effects of Neoadjuvant Chemoradiation on pTNM Staging and Its Prognostic Significance in Esophageal Cancer
Title | The Effects of Neoadjuvant Chemoradiation on pTNM Staging and Its Prognostic Significance in Esophageal Cancer |
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Authors | |
Keywords | chemoradiation Esophageal neoplasm multimodality treatment prognosis staging |
Issue Date | 2006 |
Publisher | Elsevier Inc. |
Citation | Journal Of Gastrointestinal Surgery, 2006, v. 10 n. 9, p. 1301-1311 How to Cite? |
Abstract | For 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 Identifier | http://hdl.handle.net/10722/72038 |
ISSN | 2023 Impact Factor: 2.2 2023 SCImago Journal Rankings: 0.941 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Law, S | en_HK |
dc.contributor.author | Kwong, DLW | en_HK |
dc.contributor.author | Wong, KH | en_HK |
dc.contributor.author | Kwok, KF | en_HK |
dc.contributor.author | Wong, J | en_HK |
dc.date.accessioned | 2010-09-06T06:37:44Z | - |
dc.date.available | 2010-09-06T06:37:44Z | - |
dc.date.issued | 2006 | en_HK |
dc.identifier.citation | Journal Of Gastrointestinal Surgery, 2006, v. 10 n. 9, p. 1301-1311 | en_HK |
dc.identifier.issn | 1091-255X | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/72038 | - |
dc.description.abstract | For 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.language | eng | en_HK |
dc.publisher | Elsevier Inc. | - |
dc.relation.ispartof | Journal of Gastrointestinal Surgery | en_HK |
dc.subject | chemoradiation | en_HK |
dc.subject | Esophageal neoplasm | en_HK |
dc.subject | multimodality treatment | en_HK |
dc.subject | prognosis | en_HK |
dc.subject | staging | en_HK |
dc.subject.mesh | Adult | en_HK |
dc.subject.mesh | Aged | en_HK |
dc.subject.mesh | Aged, 80 and over | en_HK |
dc.subject.mesh | Antineoplastic Combined Chemotherapy Protocols - therapeutic use | en_HK |
dc.subject.mesh | Carcinoma, Squamous Cell - diagnosis - pathology - therapy | en_HK |
dc.subject.mesh | Dose Fractionation | en_HK |
dc.subject.mesh | Esophageal Neoplasms - diagnosis - pathology - therapy | en_HK |
dc.subject.mesh | Esophagectomy | en_HK |
dc.subject.mesh | Female | en_HK |
dc.subject.mesh | Humans | en_HK |
dc.subject.mesh | Male | en_HK |
dc.subject.mesh | Middle Aged | en_HK |
dc.subject.mesh | Neoadjuvant Therapy | en_HK |
dc.subject.mesh | Neoplasm Staging | en_HK |
dc.subject.mesh | Prognosis | en_HK |
dc.title | The Effects of Neoadjuvant Chemoradiation on pTNM Staging and Its Prognostic Significance in Esophageal Cancer | en_HK |
dc.type | Article | en_HK |
dc.identifier.openurl | http://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+cancer | en_HK |
dc.identifier.email | Law, S: slaw@hku.hk | en_HK |
dc.identifier.email | Kwong, DLW: dlwkwong@hku.hk | en_HK |
dc.identifier.email | Wong, J: jwong@hkucc.hku.hk | en_HK |
dc.identifier.authority | Law, S=rp00437 | en_HK |
dc.identifier.authority | Kwong, DLW=rp00414 | en_HK |
dc.identifier.authority | Wong, J=rp00322 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.gassur.2006.06.009 | en_HK |
dc.identifier.pmid | 17114016 | - |
dc.identifier.scopus | eid_2-s2.0-33751233550 | en_HK |
dc.identifier.hkuros | 127254 | en_HK |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-33751233550&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 10 | en_HK |
dc.identifier.issue | 9 | en_HK |
dc.identifier.spage | 1301 | en_HK |
dc.identifier.epage | 1311 | en_HK |
dc.identifier.isi | WOS:000242649700019 | - |
dc.publisher.place | United States | en_HK |
dc.identifier.scopusauthorid | Law, S=7202241293 | en_HK |
dc.identifier.scopusauthorid | Kwong, DLW=15744231600 | en_HK |
dc.identifier.scopusauthorid | Wong, KH=36485841700 | en_HK |
dc.identifier.scopusauthorid | Kwok, KF=7102194177 | en_HK |
dc.identifier.scopusauthorid | Wong, J=8049324500 | en_HK |
dc.identifier.citeulike | 10439732 | - |
dc.identifier.issnl | 1091-255X | - |