JOM KITA KE POLITEKNIK

The Impact of Adjuvant Therapy on Survival Following Esophagectomy for Node-negative Esophageal Adenocarcinoma (Record no. 251)

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Personal name Rucker, A. Justin
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Title The Impact of Adjuvant Therapy on Survival Following Esophagectomy for Node-negative Esophageal Adenocarcinoma
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Date of publication, distribution, etc. 2022-02-01.
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General note /pmc/articles/PMC7502525/
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General note /pubmed/32209899
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Summary, etc. OBJECTIVE: Determine whether adjuvant chemotherapy is associated with a survival benefit in high risk T2-4a, pathologically node-negative distal esophageal adenocarcinoma. SUMMARY BACKGROUND DATA: There is minimal literature to substantiate the National Comprehensive Cancer Network (NCCN) guidelines recommending adjuvant therapy for patients with distal esophageal adenocarcinoma and no pathologic evidence of nodal disease. METHODS: The National Cancer Database was used to identify adult patients with pT2-4aN0M0 esophageal adenocarcinoma who underwent definitive surgery (2004-2015) and had characteristics considered high risk by the NCCN. Patients were stratified by receipt of adjuvant chemotherapy with or without radiation. The primary outcome was overall survival, which was evaluated using Kaplan-Meier and multivariable Cox Proportional Hazards models. A 1:1 propensity score-matched analysis was also performed to compare survival between the groups. RESULTS: 403 patients met study criteria: 313 (78%) without adjuvant therapy and 90 who received adjuvant chemotherapy with or without radiation (22%). In both unadjusted and multivariable analysis, adjuvant chemotherapy with or without radiation was not associated with a significant survival benefit compared to no adjuvant therapy. In a subgroup analysis of 335 patients without high risk features by NCCN criteria, adjuvant chemotherapy was not independently associated with a survival benefit. CONCLUSION: In this analysis, adjuvant chemotherapy with or without radiation was not associated with a significant survival benefit in completely resected, pathologically node-negative distal esophageal adenocarcinoma, independent of presence of high risk characteristics. The risks and benefits of adjuvant therapy should be weighed before offering it to patients with completely resected pT2-4aN0M0 esophageal adenocarcinoma.
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Personal name Raman, Vignesh
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9 (RLIN) 899
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Personal name Jawitz, Oliver K.
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Personal name Voigt, Soraya L.
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Personal name Harpole, David H.
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Personal name D'Amico, Thomas A.
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Personal name Tong, Betty C.
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9 (RLIN) 904
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Note Ann Surg
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Uniform Resource Identifier <a href="http://dx.doi.org/10.1097/SLA.0000000000003886">http://dx.doi.org/10.1097/SLA.0000000000003886</a>
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