Long-term follow-up confirms that neoadjuvant chemoradiotherapy improves overall survival when added to surgery in patients with resectable esophageal or esophagogastric junctional cancer, a new study published online ahead of print in the journal The Lancet Oncology has shown.
Initial results from the CROSS Study demonstrated improved 5-year overall survival with chemoradiotherapy plus surgery compared with surgery alone in patients with squamous cell carcinoma and adenocarcinoma of the esophagus or esophagogastric junction. Now, researchers report the long-term results after a minimum of 5 years follow-up.
For the study, researchers enrolled 368 patients with clinically resectable, locally advanced esophageal or esophagogastric junctional cancer. Participants were randomly assigned to receive neoadjuvant carboplatin and paclitaxel with concurrent radiotherapy followed by surgery, or surgery alone.
Results showed that after a median follow-up 84.1 months, median overall survival was 48.6 months and 24.0 months with neoadjuvant chemoradiotherapy plus surgery and surgery alone, respectively (HR = 0.68; 95% CI: 0.53, 0.88; P=0.003)
Among patients with squamous cell carcinoma, median overall survival was 81.6 months and 21.1 months, respectively (HR = 0.48; 95% CI: 0.28, 0.83;P=0.008), and 43.2 and 27.1 months, respectively for patients with adenocarcinoma (HR = 0.73; 95% CI: 0.55, 0.98; P=0.038).
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The findings suggest that neoadjuvant chemoradiotherapy followed by surgical resection should be the standard of care for patients with resectable locally advanced adenocarcinoma or squamous cell carcinoma of the esophagus or esophagogastric junction.
- Shapiro J, van Lanschot JJB, Holshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junction cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015. [epub ahead of print]. doi: 10.1016/S1470-2045(15)00040-6.