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Kroese TE, Dijksterhuis WPM, van Rossum PSN, et al. Prognosis of Interval Distant Metastases After Neoadjuvant Chemoradiotherapy for Esophageal Cancer. Ann Thorac Surg. 2021;113(2):482-490doi: 10.1016/j.athoracsur.2021.01.061.
Kroese, T. E., Dijksterhuis, W. P. M., van Rossum, P. S. N., Verhoeven, R. H. A., Mook, S., Haj Mohammad, N., Hulshof, M. C. C. M., van Berge Henegouwen, M. I., van Oijen, M. G. H., Ruurda, J. P., van Laarhoven, H. W. M., & van Hillegersberg, R. (2022). Prognosis of Interval Distant Metastases After Neoadjuvant Chemoradiotherapy for Esophageal Cancer. The Annals of thoracic surgery, 113(2), 482-490. https://doi.org/10.1016/j.athoracsur.2021.01.061
Kroese, Tiuri E, et al. "Prognosis of Interval Distant Metastases After Neoadjuvant Chemoradiotherapy for Esophageal Cancer." The Annals of thoracic surgery vol. 113,2 (2022): 482-490. doi: https://doi.org/10.1016/j.athoracsur.2021.01.061
Kroese TE, Dijksterhuis WPM, van Rossum PSN, Verhoeven RHA, Mook S, Haj Mohammad N, Hulshof MCCM, van Berge Henegouwen MI, van Oijen MGH, Ruurda JP, van Laarhoven HWM, van Hillegersberg R. Prognosis of Interval Distant Metastases After Neoadjuvant Chemoradiotherapy for Esophageal Cancer. Ann Thorac Surg. 2022 Feb;113(2):482-490. doi: 10.1016/j.athoracsur.2021.01.061. Epub 2021 Feb 18. PMID: 33610543.
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Ann Thorac Surg. 2022 Feb;113(2):482-490. doi: 10.1016/j.athoracsur.2021.01.061. Epub 2021 Feb 18.

Prognosis of Interval Distant Metastases After Neoadjuvant Chemoradiotherapy for Esophageal Cancer.

The Annals of thoracic surgery

Tiuri E Kroese, Willemieke P M Dijksterhuis, Peter S N van Rossum, Rob H A Verhoeven, Stella Mook, Nadia Haj Mohammad, Maarten C C M Hulshof, Mark I van Berge Henegouwen, Martijn G H van Oijen, Jelle P Ruurda, Hanneke W M van Laarhoven, Richard van Hillegersberg

Affiliations

  1. Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
  2. Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Department of Medical Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.
  3. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
  4. Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands.
  5. Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
  6. Department of Radiation Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.
  7. Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.
  8. Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
  9. Department of Medical Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.
  10. Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands. Electronic address: [email protected].

PMID: 33610543 DOI: 10.1016/j.athoracsur.2021.01.061

Abstract

BACKGROUND: In esophageal cancer patients, distant metastases develop between the start of neoadjuvant chemoradiotherapy and planned surgery, so-called interval metastases. The primary aim of this study was to assess management, overall survival (OS), and prognostic factors for OS in these patients. A secondary aim was to compare OS with synchronous metastatic patients.

METHODS: Esophageal cancer patients with interval distant metastases were identified from the Netherlands Cancer Registry (2010 to 2017). Management was categorized into metastasis-directed therapy (MDT), primary tumor resection, or best supportive care (BSC). The OS was calculated from the diagnosis of the primary tumor. Prognostic factors affecting OS were studied using Cox proportional hazard models. Propensity score-matching (1:3) generated matched cases with synchronous distant metastases.

RESULTS: In all, 208 patients with interval metastases were identified: in 87 patients (42%) MDT was initiated; in 10%, primary tumor resection only; in 7%, primary tumor resection plus MDT; and in 41%, BSC. Median OS was 10 months (interquartile range, 8.6 to 11.1). Compared with BSC, superior OS was independently associated with MDT (hazard ratio [HR] 0.36; 95% confidence interval [CI], 0.26 to 0.49), primary tumor resection (HR 0.55; 95% CI, 0.33 to 0.94), and primary tumor resection plus MDT (HR 0.20; 95% CI, 0.10 to 0.38). Worse OS was independently associated with signet ring cell carcinoma (HR 1.92; 95% CI, 1.12 to 3.28) and poor differentiation grade (HR 1.96; 95% CI, 1.35 to 2.83). The OS was comparable between matched patients with interval and synchronous distant metastases (10.2 versus 9.4 months, P = .760).

CONCLUSIONS: In esophageal cancer patients treated with neoadjuvant chemoradiotherapy with interval distant metastases, the OS was poor and comparable to that of synchronous metastatic patients.

Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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