Significant understaging is seen in clinically staged T2N0 esophageal cancer patients undergoing esophagectomy |
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| Authors: | B. S. Diggs R. A. Luna B. C. Sheppard P. H. Schipper B. H. Tieu G. Bakis G. M. Vaccaro J. M. Holland K. M. Gatter M. A. Conroy C. A. Thomas Jr. J. G. Hunter |
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| Affiliation: | 1. Department of Surgery, Digestive Health Center & the Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA;2. Department of Surgery, Division of Cardiothoracic Surgery & the Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA;3. Department of Medicine, Division of Gastroenterology & the Digestive Health Center, Oregon Health and Science University, Portland, Oregon, USA;4. Department of Medicine, Division of Hematology & Medical Oncology, Oregon Health and Science University, Portland, Oregon, USA;5. Department of Radiation Medicine & the Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA;6. Department of Pathology, Oregon Health and Science University, Portland, Oregon, USA |
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| Abstract: | This study aimed to determine the impact of preoperative staging on the treatment of clinical T2N0 (cT2N0) esophageal cancer patients undergoing esophagectomy. We reviewed a retrospective cohort of 27 patients treated at a single institution between 1999 and 2011. Clinical staging was performed with computed tomography, positron emission tomography, and endoscopic ultrasound. Patients were separated into two groups: neoadjuvant therapy followed by surgery (NEOSURG) and surgery alone (SURG). There were 11 patients (41%) in the NEOSURG group and 16 patients (59%) in the SURG group. In the NEOSURG group, three of 11 patients (27%) had a pathological complete response and eight (73%) were partial or nonresponders after neoadjuvant therapy. In the SURG group, nine of 16 patients (56%) were understaged, 6 (38%) were overstaged, and 1 (6%) was correctly staged. In the entire cohort, despite being clinically node negative, 14 of 27 patients (52%) had node‐positive disease (5/11 [45%] in the NEOSURG group, and 9/16 [56%] in the SURG group). Overall survival rate was not statistically significant between the two groups (P = 0.96). Many cT2N0 patients are clinically understaged and show no preoperative evidence of node‐positive disease. Consequently, neoadjuvant therapy may have a beneficial role in treatment. |
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| Keywords: | chemotherapy esophageal cancer oesophageal cancer esophagectomy neoadjuvant therapy radiation therapy |
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