caa a22 4500 445338296 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1314-7 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1314-7 Improved Outcomes in the Management of Esophageal Cancer with the Addition of Surgical Resection to Chemoradiation Therapy [Elektronische Daten] [Shaun McKenzie, Brian Mailey, Avo Artinyan, Michelle Metchikian, Stephen Shibata, Kemp Kernstine, Joseph Kim] Background: For patients with locally advanced esophageal cancer, prospective randomized clinical trials have reported no added value of surgical resection to chemoradiation alone. Using a large regional cancer registry, our objective was to determine whether curative-intent esophageal resection provided a survival advantage in the multimodality management of esophageal cancer. Materials and Methods: Using the Los Angeles County Cancer Surveillance Program (CSP), we identified all patients with local and regional (i.e., AJCC Stages I-III) esophageal cancer during the years 1988-2006. Clinical and pathologic data included patient demographics, tumor information, indication for surgery, lymph node status, and timing of therapy. Overall survival was assessed by the Kaplan-Meier method, and multivariate Cox-regression analysis was performed. Results: From CSP, 2233 patients with esophageal cancer were identified. Median survival (MS) of the entire cohort was 13.1months. We stratified this cohort into patients who received chemoradiation alone (n=645) and patients who received trimodality therapy (n=286) (i.e., chemoradiation and surgery). Patients had significantly improved survival with trimodality therapy compared with chemoradiation alone (MS 25.2 vs. 12.3months, respectively; P<0.001). The survival advantage with trimodality therapy was observed for patients with squamous cell carcinoma (MS 24.5 vs. 12.8 months, respectively; P<0.001) and adenocarcinoma (MS 25.9 vs. 10.6months, respectively; P<0.001). By multivariate analysis, trimodality therapy was a significant prognostic factor for improved survival in patients with esophageal cancer (hazard ratio [HR] 0.66, 95% confidence interval [95% CI]: 0.56-0.77, P<0.001). Conclusions: Our data indicate that surgical resection remains an important component of the multimodality management of esophageal cancer. Society of Surgical Oncology, 2010 McKenzie Shaun Division of Surgical Oncology, Department of Surgery, University of Kentucky School of Medicine, Lexington, KY, USA aut Mailey Brian Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut Artinyan Avo Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA aut Metchikian Michelle Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut Shibata Stephen Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut Kernstine Kemp Division of Thoracic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut Kim Joseph Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 551-558 1068-9265 18:2<551 2011 18 10434 https://doi.org/10.1245/s10434-010-1314-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1314-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- McKenzie Shaun Division of Surgical Oncology, Department of Surgery, University of Kentucky School of Medicine, Lexington, KY, USA aut NATIONALLICENCE 700 1- Mailey Brian Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut NATIONALLICENCE 700 1- Artinyan Avo Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA aut NATIONALLICENCE 700 1- Metchikian Michelle Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut NATIONALLICENCE 700 1- Shibata Stephen Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut NATIONALLICENCE 700 1- Kernstine Kemp Division of Thoracic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut NATIONALLICENCE 700 1- Kim Joseph Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 551-558 1068-9265 18:2<551 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer