TY - JOUR
T1 - Active surveillance of oesophageal cancer after response to neoadjuvant chemoradiotherapy
T2 - dysphagia is uncommon
AU - Valkema, Maria J.
AU - Spaander, Manon C.W.
AU - Boonstra, Jurjen J.
AU - van Dieren, Jolanda M.
AU - Hazen, Wouter L.
AU - Erkelens, G. Willemien
AU - Holster, I. Lisanne
AU - van der Linden, Andries
AU - van der Linde, Klaas
AU - Oostenbrug, Liekele E.
AU - Quispel, Rutger
AU - Schoon, Erik J.
AU - Siersema, Peter D.
AU - Doukas, Michail
AU - Eyck, Ben M.
AU - van der Wilk, Berend J.
AU - van der Sluis, Pieter C.
AU - Wijnhoven, Bas P.L.
AU - Lagarde, Sjoerd M.
AU - van Lanschot, J. Jan B.
N1 - Funding Information:
The preSANO trial was funded by the KWF Dutch Cancer Society. The SANO trial is currently funded by the KWF Dutch Cancer Society and ZonMw. Acknowledgements
Publisher Copyright:
© 2023 The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - BACKGROUND: Active surveillance is being investigated as an alternative to standard surgery after neoadjuvant chemoradiotherapy for oesophageal cancer. It is unknown whether dysphagia persists or develops when the oesophagus is preserved after neoadjuvant chemoradiotherapy. The aim of this study was to assess the prevalence and severity of dysphagia during active surveillance in patients with an ongoing response. METHODS: Patients who underwent active surveillance were identified from the Surgery As Needed for Oesophageal cancer ('SANO') trial. Patients without evidence of residual oesophageal cancer until at least 6 months after neoadjuvant chemoradiotherapy were included. Study endpoints were assessed at time points that patients were cancer-free and remained cancer-free for the next 4 months. Dysphagia scores were evaluated at 6, 9, 12, and 16 months after neoadjuvant chemoradiotherapy. Scores were based on the European Organisation for Research and Treatment of Cancer oesophago-gastric quality-of-life questionnaire 25 (EORTC QLQ-OG25) (range 0-100; no to severe dysphagia). The rate of patients with a (non-)traversable stenosis was determined based on all available endoscopy reports. RESULTS: In total, 131 patients were included, of whom 93 (71.0 per cent) had adenocarcinoma, 93 (71.0 per cent) had a cT3-4a tumour, and 33 (25.2 per cent) had a tumour circumference of greater than 75 per cent at endoscopy; 60.8 to 71.0 per cent of patients completed questionnaires per time point after neoadjuvant chemoradiotherapy. At all time points after neoadjuvant chemoradiotherapy, median dysphagia scores were 0 (interquartile range 0-0). Two patients (1.5 per cent) underwent an intervention for a stenosis: one underwent successful endoscopic dilatation; and the other patient required temporary tube feeding. Notably, these patients did not participate in questionnaires. CONCLUSION: Dysphagia and clinically relevant stenosis are uncommon during active surveillance.
AB - BACKGROUND: Active surveillance is being investigated as an alternative to standard surgery after neoadjuvant chemoradiotherapy for oesophageal cancer. It is unknown whether dysphagia persists or develops when the oesophagus is preserved after neoadjuvant chemoradiotherapy. The aim of this study was to assess the prevalence and severity of dysphagia during active surveillance in patients with an ongoing response. METHODS: Patients who underwent active surveillance were identified from the Surgery As Needed for Oesophageal cancer ('SANO') trial. Patients without evidence of residual oesophageal cancer until at least 6 months after neoadjuvant chemoradiotherapy were included. Study endpoints were assessed at time points that patients were cancer-free and remained cancer-free for the next 4 months. Dysphagia scores were evaluated at 6, 9, 12, and 16 months after neoadjuvant chemoradiotherapy. Scores were based on the European Organisation for Research and Treatment of Cancer oesophago-gastric quality-of-life questionnaire 25 (EORTC QLQ-OG25) (range 0-100; no to severe dysphagia). The rate of patients with a (non-)traversable stenosis was determined based on all available endoscopy reports. RESULTS: In total, 131 patients were included, of whom 93 (71.0 per cent) had adenocarcinoma, 93 (71.0 per cent) had a cT3-4a tumour, and 33 (25.2 per cent) had a tumour circumference of greater than 75 per cent at endoscopy; 60.8 to 71.0 per cent of patients completed questionnaires per time point after neoadjuvant chemoradiotherapy. At all time points after neoadjuvant chemoradiotherapy, median dysphagia scores were 0 (interquartile range 0-0). Two patients (1.5 per cent) underwent an intervention for a stenosis: one underwent successful endoscopic dilatation; and the other patient required temporary tube feeding. Notably, these patients did not participate in questionnaires. CONCLUSION: Dysphagia and clinically relevant stenosis are uncommon during active surveillance.
UR - http://www.scopus.com/inward/record.url?scp=85169848891&partnerID=8YFLogxK
U2 - 10.1093/bjs/znad211
DO - 10.1093/bjs/znad211
M3 - Article
C2 - 37418342
AN - SCOPUS:85169848891
SN - 0007-1323
VL - 110
SP - 1381
EP - 1386
JO - The British journal of surgery
JF - The British journal of surgery
IS - 10
ER -
