We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Geographic Distribution of Regional Metastatic Nodes Affects the Outcome of Trimodality-Eligible Patients with Esophageal Adenocarcinoma.
- Authors
Shiozaki, Hironori; Slack, Rebecca; Sudo, Kazuki; Elimova, Elena; Wadhwa, Roopma; Chen, Hsian-Chun; Skinner, Heath D.; Komaki, Ritsuko; Lee, Jeffrey H.; Weston, Brian; Bhutani, Manoop S.; Blum, Mariela A.; Rogers, Jane E.; Maru, Dipen M.; Hofstetter, Wayne L.; Ajani, Jaffer A.
- Abstract
Background/Aim: Malignant nodes in patients with localized esophageal adenocarcinoma (L-EAC) portend a poor prognosis. We assessed the correlation of the distribution of nodes with the outcome of patients undergoing chemoradiation/surgery (trimodality therapy). Methods: We studied 209 L-EAC patients who had confirmed or suspicious nodes at baseline staging. All patients received trimodality therapy and were grouped according to the nodal geography: above the diaphragm (AD), below the diaphragm (BD), or above and below the diaphragm (ABD). Survival estimates were calculated using the Kaplan-Meier method, and the outcomes of the groups were assessed by the log-rank test. Results: Patients were primarily Caucasian (91%) and male (93%), with a baseline stage III L-EAC (89%). The median follow-up was 2.8 years (range, 0.4-11.7). Of the 209 patients, 35% (n = 73) had AD nodes, 20% (n = 41) had BD nodes, and 45% (n = 95) had ABD nodes. ABD patients had a 5-year overall survival rate of 33%, whereas this rate was 55% in AD patients and 60% in BD patients (p = 0.02). Patients with a higher histology grade were also at a higher risk of relapse and had a poor survival (p < 0.01 for both). Conclusions: L-EAC patients in the ABD group had the worst outcome after trimodality treatment compared to those in the AD or BD group. Novel strategies are needed for ABD patients. © 2015 S. Karger AG, Basel
- Subjects
TEXAS; ADENOCARCINOMA; METASTASIS; ESOPHAGEAL tumors; ACADEMIC medical centers; BIOPSY; CHI-squared test; COMBINED modality therapy; DIAGNOSTIC imaging; FISHER exact test; HEALTH care teams; LONGITUDINAL method; MULTIVARIATE analysis; POPULATION geography; REGRESSION analysis; RESEARCH funding; TREATMENT effectiveness; PROPORTIONAL hazards models; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; LOG-rank test; KRUSKAL-Wallis Test; PROGNOSIS
- Publication
Oncology, 2015, Vol 88, Issue 6, p332
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000368611