The natural history and effect of adjuvant therapy on resected AJCC stage I-II lymph node-negative pancreatic cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 264-264
Author(s):  
Shaun McKenzie ◽  
Bin Huang ◽  
Thomas Tucker ◽  
Patrick McGrath ◽  
Dennie V. Jones ◽  
...  
Keyword(s):  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Cox Regression ◽  
Early Stage ◽  
Stage I ◽  
Lymph Node Status ◽  
Node Negative ◽  
The Impact

264 Background: Previous investigation has suggested that early stage, lymph node negative pancreatic adenocarcinoma (PAC) has a relatively good prognosis and adjuvant therapy provides little benefit over surgery alone. The purpose of our trial was to evaluate patients with stage I-II PAC receiving surgical resection to determine their clinical characteristics, overall outcome, and the impact of adjuvant therapy on survival. Methods: Utilizing the population-based registry data from the Kentucky Cancer Registry (KCR) we identified patients with lymph node negative, AJCC I-II, PAC who underwent pancreatic resection during the years of 1995-2008. Patients were further stratified by receipt of surgery alone versus surgery with adjuvant chemotherapy or chemoradiation. Clinical and pathologic data included patient demographics, tumor characteristics, and lymph node status. Kaplan-Meier and Cox-regression survival analyses were performed. Results: During the study period, 203 patients meeting criteria were identified from the KCR. Median survival (MS) for the entire cohort was 21.7 months. The majority of patients were >70 years old, Caucasian, had well or moderately differentiated tumors and tumors <5cm. 46% (n=94) and 54% (n=109) of patients had stage I and II disease respectively. When stratified by surgery only (n=119, 59%) versus adjuvant therapy (n=84, 41%), only younger age predicted receipt of adjuvant therapy (p=0.002). Adjuvant therapy provided no benefit over surgery alone regardless of stage (stage I MS: 21.5 vs. 24.7 months, p=0.97 and stage II MS: 24.2 vs. 18.0, p=0.13, respectively). By multivariate analysis, only tumor size >5cm predicted worse survival (HR 2.32, CI 1.21-4.45, p=0.012). Age, stage, adjuvant therapy, differentiation, and lymph node retrieval had no impact on survival. Conclusions: Our data indicate that the survival for surgically resected early stage, lymph node negative pancreatic adenocarcinoma remains poor and is not improved by the addition of adjuvant chemotherapy. These findings should be considered when designing future adjuvant therapy trials for this deadly disease.

Neoadjuvant Therapy Followed by Resection Versus Upfront Resection for Resectable Pancreatic Cancer: A Propensity Score Matched Analysis

2017 ◽  
Vol 35 (5) ◽  
pp. 515-522 ◽  
Author(s):  
Ali A. Mokdad ◽  
Rebecca M. Minter ◽  
Hong Zhu ◽  
Mathew M. Augustine ◽  
Matthew R. Porembka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Early Stage ◽  
Clinical Stage ◽  
Pancreatic Head ◽  
Hazard Ratio ◽  
Stage I

Purpose To compare overall survival between patients who received neoadjuvant therapy (NAT) followed by resection and those who received upfront resection (UR)—as well as a subgroup of UR patients who also received adjuvant therapy—for early-stage resectable pancreatic adenocarcinoma. Patients and Methods Adult patients with resected, clinical stage I or II adenocarcinoma of the head of the pancreas were identified in the National Cancer Database from 2006 to 2012. Patients who underwent NAT followed by curative-intent resection were matched by propensity score with patients whose tumors were resected upfront. Overall survival was compared by using a Cox proportional hazards regression model. Early postoperative and oncologic outcomes were evaluated. Results We identified 15,237 patients with clinical stage I or II resected pancreatic head adenocarcinoma. From the NAT group, 2,005 patients (95%) were matched with 6,015 patients who underwent UR. The NAT group was associated with improved survival compared with UR (median survival, 26 months v 21 months, respectively; stratified log-rank P < .01; hazard ratio, 0.72; 95% CI, 0.68 to 0.78). Patients in the UR group had higher pathologic T stage (pT3 and T4: 86% v 73%; P < .01), higher positive lymph nodes (73% v 48%; P < .01), and higher positive resection margin (24% v 17%; P < .01). Compared with a subset of UR patients who received adjuvant therapy, NAT patients had a better survival (adjusted hazard ratio, 0.83; 95% CI, 0.73 to 0.89). Conclusion NAT followed by resection has a significant survival benefit compared with UR in early-stage, resected pancreatic head adenocarcinoma. These findings support the use of NAT, particularly as a patient selection tool, in the management of resectable pancreatic adenocarcinoma.

An assessment of the impact of geographic variation on resection rates and survival for early-stage pancreatic adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15052-e15052
Author(s):  
Bradley D. McDowell ◽  
Brian J. Smith ◽  
Anna M Button ◽  
James R. Howe ◽  
Elizabeth A. Chrischilles ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Pancreatic Adenocarcinoma ◽  
Early Stage ◽  
Stage I ◽  
Stage Ii ◽  
Survival Times ◽  
Resection Rate ◽  
Selection Factors ◽  
The Impact

e15052 Background: Pancreatic resection is the only known curative option for pancreatic adenocarcinoma. Resection has been previously reported to be underutilized in patients with early stage disease. To develop a better understanding of this issue and control for treatment selection factors, we examined the relationship between geographic area resection rates and survival in patients with stage I/II pancreatic cancer. Methods: We queried Surveillance, Epidemiology, and End Results (SEER) data for patients with stage I/II cancer of the pancreatic head diagnosed from 2004-2009. We excluded patients with less than 3mo survival. Resection rates were calculated within Health Service Areas (HSAs) across all 18 SEER regions. Resection rate was defined as the number of patients who had an operation divided by the total number diagnosed with early stage pancreatic cancer. Multivariate Cox regression was used to estimate the overall survival effect of HSA rates while controlling for age, gender, marital status, poverty level, education, and AJCC stage. Results: 8,323 patients with stage I (n=1,454) and stage II (n=6,869) disease were analyzed. Pancreatectomy was performed in 476 patients (32.7%) with stage I disease and 3,846 (56.0%) with stage II disease. HSA resection rates were arranged into five groups (quintiles) which ranged from 42.7 to 65.7% (Table). Across the quintiles, median overall survival increased from 11 to 14 months, suggesting a positive association with resection rate. Multivariate analysis revealed that for every 10.00% increase in resection rate, the risk of overall death decreased by 5.26% (p<0.001). Conclusions: Patients with early stage pancreatic cancer who live in areas with higher resection rates have longer average survival times. Because geography should not influence treatment response, we conclude that efforts to raise resection rates should increase survival times in patients for whom there is uncertainty about the risk/benefits of resection. [Table: see text]

Factors affecting the administration of adjuvant therapy in patients with pancreatic adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15087-e15087
Author(s):  
Pablo Emilio Serrano Aybar ◽  
Peter Tae Wan Kim ◽  
Kenneth Leung ◽  
Sean P. Cleary ◽  
Steven Gallinger ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Multivariate Logistic Regression Analysis ◽  
Major Complication ◽  
High Volume ◽  
Lower Probability ◽  
Node Negative ◽  
Factors Affecting ◽  
Major Complications ◽  
The Impact

e15087 Background: Adjuvant therapy for pancreatic adenocarcinoma is now considered standard of care. The proportion of patients receiving adjuvant therapy (ADT) following pancreatic resection is a good quality indicator of cancer care. The aim of this study was to evaluate factors associated with receiving ADT in patients with pancreatic cancer. Methods: Between years 2000-2010, all patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma at a single high-volume hepatotopancreatobiliary center were evaluated. The impact of demographic, peri-operative and pathological risk factors affecting the administration of ADT were analyzed using univariate and multivariate logistic regression analysis. Results: There were 258 patients identified. Median age was 65 (37-84) years, 54% were females. There was a 15% margin positivity rate, 14% pancreatic leak rate, 14.7% major complication rate, and 1.2% 90 day/in-hospital mortality rate. Overall, 160/258 (70%) of patients received adjuvant therapy. On multivariate analysis; age, presence of major complications, node-negative disease and earlier era (2000-2004) were significantly associated with a lower probability of receiving ADT. Reasons for not receiving ADT were; patient preference: 20/67 (32%), not recommended: 14/67 (23%), disease recurrence: 12/67 (9.5%) and being medically unfit for ADT: 18/67 (11.5%). None of these reasons were different between time-periods except for fewer patients being offered ADT from 2000-2005 (15.4% vs. 2.5%, p <0.001). Conclusions: Thirty percent of patients do not receive ADT following pancreatectomy. Those with advanced age; node-negative disease and those who had major complications after pancreaticoduodenectomy were less likely to receive ADT. The impact of these factors should be taken into account when considering the administration of ADT.

Patterns of systemic treatment utilization in ER+/PgR+/HER2+, early-stage breast cancer (BC): An analysis of the National Cancer Database.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 547-547
Author(s):  
Zeina A. Nahleh ◽  
Brian Hobbs ◽  
Elizabeth Elimimian ◽  
Wei (Auston) Wei ◽  
Annie Gupta ◽  
...  
Keyword(s):  
African Americans ◽  
Endocrine Therapy ◽  
Early Stage ◽  
Adjuvant Endocrine Therapy ◽  
Stage I ◽  
Treatment Utilization ◽  
National Cancer Database ◽  
Node Negative ◽  
Risk Of Death ◽  
The Impact

547 Background: The preferences and trends of treatment utilization of adjuvant endocrine therapy (ET) versus chemotherapy (CH) for small node-negative triple positive (TP) BC are unclear. We sought to determine these preferences and assess the impact on outcome. Methods: This is a retrospective study from the National Cancer Database including patients with TP stage I BC, 2004-2015. Treatment selection was evaluated for association with patient clinical and demographic characteristics using logistic regression. Overall survival (OS) was estimated using the Kaplan-Meier method and compared among patient and treatment cohorts by log-rank test and Cox regression. Results: Of 37,777 patients analyzed, 79% were White (Non-Hispanics), 10% African Americans, and 5% Hispanic/Latinos. 57% were 50-70 years old. 86% received adjuvant endocrine therapy versus 14% CH first. Around 40 % of all patients received anti-Her2 therapy. Patients younger than 70 years, with male BC, diagnosed with poorly differentiated BC, African Americans and Hispanics were more likely to be treated with chemotherapy. OS rate at 5-year was 92.3% (95% CI: 0.918-0.928). In multivariate analysis for patients with survival data, an increased rate of death was associated with: treatment in community versus academic/research centers, CH first versus ET, no treatment with anti-Her2 therapy, government versus private /no insurance, Native American ethnicity. A slight but statistically significant reduction in the in the risk of death at 5 years was evident for patients receiving anti-Her2 therapy plus ET therapy, 5-year OS 93.5% (CI: 89.2-98%), when compared to patients receiving anti-Her2 therapy plus CH 92.7 % (CI: 89.4-96). Conclusions: This study provides real world data of common practices in the US . The majority of patients with node negative Stage I, ER+/PR+/Her2+ BC received adjuvant ET and anti-Her2 therapy, not chemotherapy. These patients had a similar to slightly improved 5 year- survival when compared to anti-Her2 therapy plus CH, supporting the use ET plus anti-Her2 therapy in this setting. Future studies should focus on better selecting patients with hormone receptor positive and Her 2 + early stage BC who would benefit from adjuvant CH. Disparity in outcome also warrants further evaluation. [Table: see text]

Determinants of adjuvant chemotherapy use in small luminal-like breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12010-e12010
Author(s):  
Marta Bonotto ◽  
Lorenzo Gerratana ◽  
Alessandro Bettini ◽  
Marika Cinausero ◽  
Debora Basile ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Lymph Node Status ◽  
Related Factors ◽  
Luminal B

e12010 Background: The use of adjuvant chemotherapy (CT) in small luminal-like breast cancer (BC) is still heavily debated. International guidelines identify endocrine therapy as the backbone of adjuvant treatment for these patients (pts), while the addition of CT should be limited to high risk cases. The aim of this study was to evaluate the association between patient- or disease-related factors with the prescription of adjuvant CT. Methods: This retrospective study reviewed data from 559 consecutive pts with pT1 ( < 2 cm) luminal-like BC treated between 2004 and 2015 at the Department of Oncology of Udine (Italy). No restrictions were applied regarding lymph node status. The cut-off point of 1% was used to define ER and/or PgR positivity. Factors influencing the prescription of CT were investigated through uni- and multivariate logistic regression with odds ratio (OR) calculation. Prognosis was explored through Cox regression. Results: About thirty percent (173/559) of pts received adjuvant CT. By multivariate analysis, lymph node involvement was highly associated with CT prescription (OR 16.94, 95% CI 7.86-36.50, P < 0.001 for pN1; OR 3.92, 95% CI 1.45-10.58, P = 0.007 for pNmi). Tumor size drove towards the use of CT among pts with pT1c tumors (OR 12.87, 95% CI 1.49-110.88, P = 0.020) but not in pts with pT1b BC (OR 2.38, 95% CI 0.26-21.38, P = 0.437). In addition, a higher CT use was observed in pts with luminal B-like disease (OR 3.79, 95% CI 2.16-6.65, P < 0.001) or in presence of a Ki67 > 14% (OR 1.05, 95% CI 1.03-1.07, P < 0.001). On the contrary, pts with age > 60 years had a very low chance of receiving adjuvant CT (OR 0.09, 95% CI 0.04-0.20, P < 0.001). Notably, the use of CT was not associated with Disease Free Survival or Overall Survival (HR 1.3, 95% CI 0.77-2.17, P = 0.320; HR 1.05, 95% CI 0.56-2, P = 0.866; respectively). Conclusions: Nodal status, tumor size, disease sub-type, Ki67 expression and age are determinants of adjuvant CT prescription in pts with small luminal-like BC. Prospective studies are needed to identify which pts could safely avoid CT without influencing prognosis.

scholarly journals Impact of resection margin status on survival in advanced N stage pancreatic cancer – a multi-institutional analysis

2021 ◽  
Author(s):  
Christian Teske ◽  
Richard Stimpel ◽  
Marius Distler ◽  
Susanne Merkel ◽  
Robert Grützmann ◽  
...  
Keyword(s):  
Lymph Node ◽  
Resection Margin ◽  
Cox Regression ◽  
Institutional Analysis ◽  
Ductal Adenocarcinoma ◽  
Resection Margins ◽  
Lymph Node Status ◽  
Cox Regression Analysis ◽  
N Stage ◽  
The Impact

Abstract Background The present study aimed to examine the impact of microscopically tumour-infiltrated resection margins (R1) in pancreatic ductal adenocarcinoma (PDAC) patients with advanced lymphonodular metastasis (pN1–pN2) on overall survival (OS). Methods This retrospective, multi-institutional analysis included patients undergoing surgical resection for PDAC at three tertiary university centres between 2005 and 2018. Subcohorts of patients with lymph node status pN0–N2 were stratified according to the histopathological resection status using Kaplan-Meier survival analysis. Results The OS of the entire cohort (n = 620) correlated inversely with the pN status (26 [pN0], 18 [pN1], 11.8 [pN2] months, P < 0.001) and R status (21.7 [R0], 12.5 [R1] months, P < 0.001). However, there was no statistically significant OS difference between R0 versus R1 in cases with advanced lymphonodular metastases: 19.6 months (95% CI: 17.4–20.9) versus 13.6 months (95% CI: 10.7–18.0) for pN1 stage and 13.7 months (95% CI: 10.7–18.9) versus 10.1 months (95% CI: 7.9–19.1) for pN2, respectively. Accordingly, N stage–dependent Cox regression analysis revealed that R status was a prognostic factor in pN0 cases only. Furthermore, there was no significant survival disadvantage for patients with R0 resection but circumferential resection margin invasion (≤ 1 mm; CRM+; 10.7 months) versus CRM-negative (13.7 months) cases in pN2 stages (P = 0.5). Conclusions An R1 resection is not associated with worse OS in pN2 cases. If there is evidence of advanced lymph node metastasis and a re-resection due to an R1 situation (e.g. at venous or arterial vessels) may substantially increase the perioperative risk, margin clearance in order to reach local control might be avoided with respect to the OS.

Impact of adjuvant therapies on survival in patients with cholangiocarcinoma.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 360-360
Author(s):  
Laura Dover ◽  
Rojymon Jacob ◽  
Thomas Wang ◽  
Robert Oster ◽  
Derek Dubay
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Surgical Resection ◽  
Cox Regression ◽  
Tumor Stage ◽  
Rank Test ◽  
Resection Margins ◽  
Positive Margins ◽  
Number Of Patients ◽  
The Impact

360 Background: Surgical resection is the only curative option for Cholangiocarcinoma (CC) and currently there are no clear guidelines for adjuvant therapy following resection. Given the high incidence of local and distant recurrences following resection, we evaluated the impact of adjuvant chemotherapy or chemoradiation (CRT) on median survival (OS). Methods: A retrospective review was performed identifying all patients with CC who underwent curative surgical resection at our institution between 2002 and 2012. Patients who underwent aborted or palliative procedures were excluded. Survival estimates were quantified using Kaplan Meier curves, and differences between groups were compared with the log-rank test and Cox regression models. Results: During the study period, 103 patients underwent curative resection for CC at our institution. Tumor location was intrahepatic, perihilar and distal in 37% (n=38), 23% (n=24) and 40% (n=41) respectively. A total of 49 (48%) patients received adjuvant chemotherapy (n= 28) or CRT (n=21). Observation with no additional therapy was employed in the remaining 54 (52%) patients. No patient was treated using radiation alone. OS was 21.4 and 41.4 months (m) for those receiving adjuvant therapy versus observation (p=0.08). OS for adjuvant therapy versus observation were 28.4 m and 19.4 m respectively, if surgical margins were positive (p=0.036); and 79.1 m and 26.3 m respectively (p=0.4) with negative resection margins. OS was 41.4 m and 38.0 m with adjuvant chemo versus CRT respectively (p=0.1). Tumor stage was the only statistically significant pathologic indicator of outcome (p=0.019). Conclusions: A trend towards significant improvement in OS was observed with the use of adjuvant therapy among all patients following resection of CC. Adjuvant therapy significantly improved OS among CC patients with positive margins of resection. The small number of patients with negative margins of resection also benefitted, though not significantly. These data suggest that while adjuvant therapy should be considered for all patients irrespective of margin status; patients with positive margins are likely to benefit the most.

Which side is better? The impact of primary tumor side in early stage colorectal cancer (CRC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15106-e15106
Author(s):  
Margaret Lee ◽  
Andrew Mackinlay ◽  
Christine Semira ◽  
Antonio Jose Jimeno ◽  
Belinda Lee ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Primary Tumor ◽  
Early Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Early Stage Disease ◽  
Stage Iv Disease ◽  
The Impact

e15106 Background: Multiple studies have indicated the prognostic and potential predictive significance of primary tumor side in metastatic CRC. To date, the few studies examining its impact in early stage disease have either combined data across multiple stages or restricted analysis to overall survival (OS) data. A by stage analysis of the impact of tumor side on recurrence risk is critical if it is to impact adjuvant therapy decisions. Methods: We examined data from a multi-site Australian registry of consecutive patients diagnosed from 2003-2016. Tumors at and distal to the splenic flexure, including the rectum, were considered a left primary (LP). Rectal patients treated with initial chemoradiation were excluded. Clinico-pathologic and outcome data were examined. Data analysis was provided by the healthcare group at IBM Research Australia. Results: A total of 6123 patients were identified, of which 1046 (17.1%) had initial stage I, 1892 (30.9%) had stage II, 1708 (27.9%) had stage III, and 1477 (24.1%) had stage IV disease. Most patients were male (55.2%), and had a LP (n = 3818, 62.4%). Median age at diagnosis was 68.8 years, was higher in patients with a right primary (RP) (71.6 versus 67.0 years for LP, p < 0.001), with more females in the RP group (51.1% vs 41.0% for LP, p < 0.001). The proportion of RP varied by stage, highest in stage II (44.9%), lowest in stage IV (31.5%). For all stage IV disease, including metachronous cases, OS was worse with a RP (HR 1.32, 95% CI 1.14-1.53). For early stage cases, distant recurrence free survival (DRFS) was similar for RP vs LP for stage I (HR 0.63, 95% CI 0.32-1.23), better for stage II RP (HR 0.72, 95% CI 0.55-0.95) and worse for stage III RP disease (HR 1.22, 1.01-1.48). OS did not differ for RP vs LP for stage I or II disease, but was worse for stage III disease with a RP (HR 1.39, 95% CI 1.13-1.70). Furthermore, post recurrence survival was poorer in stage III RP disease (HR 1.61, 95% CI 1.33-1.96). Conclusions: Primary tumor side has potential as an important prognostic marker in early stage CRC. Our novel finding of a variable impact by stage indicate that an assessment of cohorts where recurrence data is available is critical to fully understanding the implications of tumor side for adjuvant therapy decision making.

scholarly journals Four Cycles of Docetaxel-Cyclophosphamide versus Anthracycline-Taxane as Adjuvant Chemotherapy for HER2-Negative, Axillary Lymph Node Negative Breast Cancer: A Real-World Comparison of Alberta Patients Treated 2008–2012

2021 ◽  
Vol 28 (2) ◽  
pp. 1137-1142
Author(s):  
Malek Hannouf ◽  
Atul Batra ◽  
Sasha Lupichuk
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Axillary Lymph Node ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Cancer Specific Survival ◽  
Node Negative ◽  
Significant Difference

Uncertainty exists around the need to include an anthracycline if taxane-based adjuvant chemotherapy is being used for human epidermal growth factor receptor-2 (HER2) negative and axillary lymph node negative (LNN) breast cancer. We identified all patients who were diagnosed with HER2-negative, LNN breast cancer treated with docetaxel-cyclophosphamide for four cycles (DC4) or an anthracycline-taxane (AT) regimen following surgical resection in Alberta from 2008 through 2012. We used propensity score methods to match each patient treated with AT to up to four patients treated with DC4 on potentially confounding clinicopathologic and treatment variables. We compared the 10-year invasive disease free survival (iDFS), breast cancer specific-survival (BCSS) and overall survival (OS) and assessed the effect of the type of adjuvant chemotherapy on these outcomes using Cox regression. Of the 726 eligible patients, 657 (90.5%) were treated with DC4 and 69 (9.5%) were treated with AT. Matching created a group of 202 women treated with DC4 and eliminated differences in clinicopathologic and treatment factors. There was no statistically significant difference for the treatment effects of matched DC4 patients compared to the AT patients on iDFS (75.7% vs. 76.8%, p = 0.75; hazard ratio (HR) = 1.05, 95% CI = 0.65 to 1.8), BCSS (88.1% vs. 87%, p = 0.8; HR = 0.91, 95% CI = 0.42 to 1.9), or OS (87.1% vs. 86.9%, p= 0.96; HR = 0.98, 95% CI = 0.46 to 2.1). Four cycles of DC as compared with an AT regimen yielded similar 10-year iDFS, BCSS and OS amongst patients with HER2-negative, LNN breast cancer.

685 THE IMPACT OF ADJUVANT THERAPY ON SURVIVAL FOR NODE-NEGATIVE ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A PROPENSITY SCORE MATCHED ANALYSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Xue-feng Leng ◽  
Wenwu He ◽  
Yingchun Jiang ◽  
Xuefeng Leng ◽  
Qiyu Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Propensity Score ◽  
Adjuvant Therapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Node Negative ◽  
Independent Risk Factors ◽  
The Impact

Abstract   At present, the primary treatment of esophageal cancer is surgery-based comprehensive treatment, including adjuvant therapy such as chemotherapy and/or radiotherapy. However, the role of adjuvant therapy for esophageal squamous cell carcinoma (ESCC) with pathologically node-negative (pN0) disease is controversial. This study aimed to evaluate the impact of postoperative adjuvant therapy on survival in patients with pN0 ESCC. Methods Patients with ESCC who underwent R0 esophagectomy in the Department of Thoracic Surgery of Sichuan Cancer Hospital from Jan. 2008 to Dec. 2013 were involved. Patients were divided into two groups: surgery alone (Group S) or surgery + adjuvant therapy (Group S + A). The primary outcomes were overall survival (OS) and disease-free survival (DFS) between the two groups, and every consecutive case was followed up to death or the last follow-up. Results The study involved 387 patients with pN0 ESCC. After propensity score matching, each group consisted of 150 patients. In the overall cohort, the 5-year OS (p = 0.004) and 5-year DFS (p = 0.003) rates were higher in Group S + A than in Group S. In matched samples, the same outcomes were observed (5-year OS: p = 0.026; 5-year DFS: p = 0.014). Postoperative chemotherapy was associated with longer OS (p = 0.02) and DFS (p = 0.004); T3 tumors (p = 0.004) and &lt; 15 lymph node dissections (p = 0.002) were independent risk factors for pN0 ESCC. Conclusion As the study revealed, adjuvant therapy, especially chemotherapy, prolonged OS and DFS for patients with ESCC who had pN0 disease. Fewer lymph node dissections and T3 stage tumors were independent risk factors for OS and DFS.

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