TY - JOUR
T1 - Pathological response to neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma
T2 - multicentre East Asian and Dutch database comparison
AU - Eyck, Ben M.
AU - Gao, Xing
AU - Yang, Yang
AU - van der Wilk, Berend J.
AU - Wong, Ian
AU - Wijnhoven, Bas P. L.
AU - Liu, Jun
AU - Lagarde, Sjoerd M.
AU - Ka-On, Lam
AU - Hulshof, Maarten C. C. M.
AU - Li, Zhigang
AU - Law, Simon
AU - Chao, Yin Kai
AU - van Lanschot, J. Jan B.
AU - Dutch Upper Gastrointestinal Cancer Audit (DUCA)
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - BACKGROUND: Patients with different ethnic and genetic backgrounds may respond differently to anticancer therapies. This study aimed to assess whether patients with oesophageal squamous cell carcinoma (OSCC) treated with neoadjuvant chemoradiotherapy (nCRT) in East Asia had an inferior pathological response compared with patients treated in Northwest Europe. METHODS: Patients with OSCC who underwent nCRT according to the CROSS regimen (carboplatin and paclitaxel with concurrent 41.4 Gy radiotherapy) followed by oesophagectomy between June 2012 and April 2020 were identified from East Asian and Dutch databases. The primary outcome was pCR, defined as ypT0 N0. Groups were compared using propensity score matching, adjusting for sex, Charlson Co-morbidity Index score, tumour location, cT and cN categories, interval between nCRT and surgery, and number of resected lymph nodes. RESULTS: Of 725 patients identified, 133 remained in each group after matching. A pCR was achieved in 37 patients (27.8 per cent) in the Asian database and 58 (43.6 per cent) in the Dutch database (P = 0.010). The rate of ypT1-4 was higher in Asian than Dutch data (66.2 and 49.6 per cent; P = 0.004). The ypN1-3 rate was 44.4 per cent in the Asian and 33.1 per cent in the Dutch data set. Clear margins were achieved in 92.5 per cent of Asian and 95.5 per cent of Dutch patients. CONCLUSION: Regional differences in responses to CROSS nCRT for oesophageal cancer were apparent, the origin of which will need evaluation.
AB - BACKGROUND: Patients with different ethnic and genetic backgrounds may respond differently to anticancer therapies. This study aimed to assess whether patients with oesophageal squamous cell carcinoma (OSCC) treated with neoadjuvant chemoradiotherapy (nCRT) in East Asia had an inferior pathological response compared with patients treated in Northwest Europe. METHODS: Patients with OSCC who underwent nCRT according to the CROSS regimen (carboplatin and paclitaxel with concurrent 41.4 Gy radiotherapy) followed by oesophagectomy between June 2012 and April 2020 were identified from East Asian and Dutch databases. The primary outcome was pCR, defined as ypT0 N0. Groups were compared using propensity score matching, adjusting for sex, Charlson Co-morbidity Index score, tumour location, cT and cN categories, interval between nCRT and surgery, and number of resected lymph nodes. RESULTS: Of 725 patients identified, 133 remained in each group after matching. A pCR was achieved in 37 patients (27.8 per cent) in the Asian database and 58 (43.6 per cent) in the Dutch database (P = 0.010). The rate of ypT1-4 was higher in Asian than Dutch data (66.2 and 49.6 per cent; P = 0.004). The ypN1-3 rate was 44.4 per cent in the Asian and 33.1 per cent in the Dutch data set. Clear margins were achieved in 92.5 per cent of Asian and 95.5 per cent of Dutch patients. CONCLUSION: Regional differences in responses to CROSS nCRT for oesophageal cancer were apparent, the origin of which will need evaluation.
UR - http://www.scopus.com/inward/record.url?scp=85143552096&partnerID=8YFLogxK
U2 - 10.1093/bjs/znac314
DO - 10.1093/bjs/znac314
M3 - Article
C2 - 36036665
SN - 0007-1323
VL - 109
SP - 1312
EP - 1318
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 12
ER -
