Erratum to: Esophageal stent fixation with endoscopic suturing device improves clinical outcomes and reduces complications in patients with locally advanced esophageal cancer prior to neoadjuvant therapy: a large multicenter experience

4536 Background: The poor prognosis associated with locally advanced esophageal cancer prompted an evaluation of combined modality treatments including neoadjuvant radiochemotherapy in combination with surgery. However, it has been well established that only patients with a complete pathological response to neoadjuvant therapy will have a significant survival benefit. Therefore, predictive markers to allow a tailored radiochemotherapy are needed. The aim of this study was to examine the association of the protein expression of survivin, an inhibitor of apoptosis, with histopathologic response to neoadjuvant radiochemotherapy and prognosis of patients with locally-advanced esophageal cancer. Methods: 59 patients with esophageal cancer (cT2–4, Nx, M0) received neoadjuvant radiochemotherapy (cisplatin, 5-FU, 36 Gy) followed by esophagectomy. Histomorphologic regression was defined as major response when resected specimens contained less than 10 % and as minor response when resected specimens contained more than 10 % of residual vital tumor cells. Pre- and post-therapeutic intratumoral protein expression of survivin was determined and correlated with clinicopathologic parameters. Results: The pre-therapeutic intratumoral survivin protein expression was not associated with any clinicopathologic factor, including histopathologic response and prognosis. Survivin protein expression was significantly reduced during neoadjuvant therapy, showing lower levels in post-therapeutic tumor samples (p<0.01). Higher postoperative survivin levels were significantly associated with a higher ypT-stage (p<0.009), a poorer histopathologic response (p<0.01) and a shorter overall survival (p<0.028). Conclusions: The intratumoral protein expression of survivin was significantly down-regulated during neoadjuvant therapy, whereas a higher survivin level after pre-operative therapy was significantly associated with a worse histopathologic response and prognosis. Therapeutic strategies which are able to reduce survivin expression or to block survivin mediated pathways might increase the histopathologic response rate and prognosis in the multimodal therapy of patients with locally-advanced esophageal cancer. No significant financial relationships to disclose.

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Removable Internally Covered Self-Expandable Metal Stents During Neoadjuvant Therapy for Locally Advanced Esophageal Cancer

The American Journal of Gastroenterology ◽

10.14309/00000434-200809001-00087 ◽

2008 ◽

Vol 103 ◽

pp. S36

Author(s):

Tercio Lopes ◽

Mohamad Eloubeidi

Keyword(s):

Esophageal Cancer ◽

Neoadjuvant Therapy ◽

Locally Advanced ◽

Metal Stents ◽

Advanced Esophageal Cancer ◽

Locally Advanced Esophageal Cancer

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P-043 Treatment intensification of neoadjuvant therapy in locally advanced esophageal cancer by addition of 2 cycles of induction chemotherapy prior to chemoradiation– an Indian experience

Annals of Oncology ◽

10.1093/annonc/mdv233.43 ◽

2015 ◽

Vol 26 ◽

pp. iv12

Author(s):

S. Saha ◽

S. Gupta ◽

S. Sarkar ◽

A. Ghosh Dastidar

Keyword(s):

Esophageal Cancer ◽

Neoadjuvant Therapy ◽

Induction Chemotherapy ◽

Locally Advanced ◽

Advanced Esophageal Cancer ◽

Treatment Intensification ◽

Indian Experience ◽

Locally Advanced Esophageal Cancer

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Adjuvant chemotherapy after trimodality therapy in locally advanced esophageal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.144 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 144-144

Author(s):

Divya Yerramilli ◽

Davendra Sohal ◽

Ursina R. Teitelbaum ◽

Paul Stephen Wissel ◽

Nevena Damjanov ◽

...

Keyword(s):

Esophageal Cancer ◽

Adjuvant Chemotherapy ◽

Clinical Outcomes ◽

Locally Advanced ◽

Pathologic Complete Response ◽

Preoperative Chemoradiation ◽

Hematologic Toxicity ◽

Advanced Esophageal Cancer ◽

Trimodality Therapy ◽

Locally Advanced Esophageal Cancer

144 Background: The benefit of adjuvant chemotherapy after preoperative chemoradiation and surgery is unclear in patients with locally advanced esophageal cancer. We studied the toxicities and clinical outcomes in patients treated with or without adjuvant chemotherapy (CTX) after trimodality therapy. Methods: Records of patients with T3+ or N+ esophageal cancer who received preoperative chemoradiation followed by surgical resection from 2003-2013 were reviewed. Patients with postoperative deaths or poor performance status within 3 months after surgery were excluded (n = 13). Tolerability and hematologic toxicities of adjuvant CTX were recorded. Clinical outcomes of patients treated with adjuvant CTX were compared with a cohort of patients who received no further therapy (NFT). Results: Of the 81 trimodality patients included in the study, 53 received CTX and 28 received NFT after surgery. Median follow-up time was 23 months. FOLFOX (34%), cisplatin/5-FU (15%), 5-FU/LV (15%), ECF (13%), and carboplatin/paclitaxel (9%) were the most commonly used adjuvant regimens. Multiple rationales for adjuvant CTX were cited, including pathologic nodal status (32%), favorable pathologic response (61%), and provider preference (51%). Grade III/IV hematologic toxicity occurred in 11% of the CTX group: leukopenia (8%/2%), neutropenia (4%/4%), and thrombocytopenia (2%/0%). Two patients in the CTX group did not complete their prescribed CTX, which was discontinued after 1 cycle. Patient and clinical characteristics between CTX and NFT patients were well-balanced, except for pathologic complete response (pCR) rates (CTX 25% vs. NFT 50%, p=0.03). Three-year OS and DFS were similar between CTX and NFT patients (74% vs 70%, 60% vs. 64%, respectively). In patients who achieved pCR (33% overall), adjuvant CTX was associated with an improved 3-yr OS (86% vs. 62%), but the difference did not reach statistical significance (p=0.22). Distant failures occurred in 11% of the CTX group and 18% of the NFT group. Conclusions: Adjuvant CTX after trimodality therapy in esophageal cancer is feasible and well-tolerated with encouraging clinical outcomes. Further studies are needed to define the role of adjuvant CTX in these patients.

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