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Objective: This study aimed to compare the postoperative and pathological outcomes between carboplatin, paclitaxel, radiotherapy (CROSS) and 5-FU, leucovorine, oxaliplatin and docetaxel (FLOT) in esophageal adenocarcinoma (EAC) patients from an international, multicenter cohort. Summary of Background Data: Ongoing debate exists around optimum approach to locally advanced EAC, with proponents for perioperative chemotherapy, such as FLOT, or multimodal therapy, in particular the CROSS regimen. Methods: Patients undergoing CROSS (n = 350) and FLOT (n = 368), followed by curative esophagectomy for EAC were identified from the Oesophagogastric Anastomosis Audit. Results: The 90-day mortality was higher after CROSS than FLOT (5% vs 1%, P = 0.005), even on adjusted analyses [odds ratio (OR): 3.97, confidence interval (CI)95%: 1.34-13.67]. Postoperative mortality in CROSS were related to higher pulmonary (74% vs 60%) and cardiac complications (42% vs 20%) compared to FLOT. CROSS was associated with higher pathologic complete response (pCR) rates (18% vs 10%, P = 0.004) and margin-negative resections (93% vs 76%, P < 0.001) compared with FLOT. On adjusted analyses, CROSS was associated with higher pCR rates (OR: 2.05, CI95%: 1.26-3.34) and margin-negative resections (OR: 4.55, CI95%: 2.70-7.69) compared to FLOT. Conclusions: This study provides real-world data CROSS was associated with higher 90-day mortality than FLOT, related to cardio-pulmonary complications with CROSS. These warrant a further review into causes and mechanisms in selected patients, and at minimum suggest the need for strict radiation therapy quality assurance. Research into impact of higher pCR rates and R0 resections with CROSS compared to FLOT on long-term survival is needed.
Postoperative and Pathological Outcomes of CROSS and FLOT as Neoadjuvant Therapy for Esophageal and Junctional Adenocarcinoma: An International Cohort Study From the Oesophagogastric Anastomosis Audit (OGAA)
Steering Committee;Alderson D.;Bundred J.;Rpt E.;Gossage J.;Griffiths E. A.;Jefferies B.;Kamarajah S. K.;McKay S.;Mohamed;Nepogodiev D.;Siaw- Acheampong K.;Singh P.;Van Hillegersberg R.;Vohra R.;Wanigasooriya K.;Whitehouse T.;National Leads;Gjata A.;Moreno J. I.;Takeda F. R.;Kidane B.;Guevara Castro R.;Harustiak T.;Bekele A.;Kechagias A.;Gockel;Kennedy A.;Da Roit A.;Bagajevas A.;Azagra J. S.;Mahendran H. A.;Mejia-Fernandez L.;Wijnhoven B. P. L.;El Kafsi J.;Sayyed R. H.;Sousa M.;Sampaio A. S.;Negoi;Blanco R.;Wallner B.;Schneider P. M.;Hsu P. K.;Isik A.;Leads S.;Gananadha S.;Wills;Devadas M.;Duong C.;Talbot M.;Hii M. W.;Jacobs R.;Andreollo N. A.;Johnston B.;Darling G.;Isaza-Restrepo A.;Rosero G.;Arias-Amezquita F.;Raptis D.;Gaedcke J.;Reim D.;Izbicki J.;Egberts J. H.;Dikinis S.;Kjaer D. W.;Larsen M. H.;Achiam M. P.;Saarnio J.;Theodorou D.;Liakakos T.;Korkolis D. P.;Robb W. B.;Collins C.;Murphy T.;Reynolds J.;Tonini;Migliore M.;Bonavina L.;Valmasoni M.;Bardini R.;Weindelmayer J.;Terashima M.;White R. E.;Alghunaim E.;Elhadi M.;Leon-Takahashi A. M.;Medina-Franco H.;Lau P. C.;Okonta K. E.;Heisterkamp J.;Rosman C.;Van Hillegersberg R.;Beban G.;Babor R.;Gordon A.;Rossaak J. I.;Pal K. M. I.;Qureshi A. U.;Naqi S. A.;Syed A. A.;Barbosa J.;Vicente C. S.;Leite J.;Freire J.;Casaca R.;Costa R. C. T.;Scurtu R. R.;Mogoanta S. S.;Bolca C.;Constantinoiu S.;Sekhniaidze D.;Bjelovic M.;So J. B. Y.;Gacevski G.;Loureiro C.;Pera M.;Bianchi A.;Moreno Gijon M.;Martin Fernandez J.;Trugeda Carrera M. S.;Vallve-Bernal M.;Citores Pascual M. A.;Elmahi S.;Halldestam;Hedberg J.;Monig S.;Gutknecht S.;Tez M.;Guner A.;Tirnaksiz M. B.;Colak E.;Sevinc B.;Hindmarsh A.;Khan;Khoo D.;Byrom R.;Gokhale J.;Wilkerson P.;Jain P.;Chan D.;Robertson K.;Iftikhar S.;Skipworth R.;Forshaw M.;Higgs S.;Gossage J.;Nijjar R.;Viswanath Y. K. S.;Turner P.;Dexter S.;Boddy A.;Allum W. H.;Oglesby S.;Cheong E.;Beardsmore D.;Vohra R.;Maynard N.;Berrisford R.;Mercer S.;Puig S.;Melhado R.;Kelty C.;Underwood T.;Dawas K.;Lewis W.;Al-Bahrani A.;Bryce G.;Thomas M.;Arndt A. T.;Palazzo F.;Meguid R. A.;Collaborators;Fergusson J.;Beenen E.;Mosse C.;Salim J.;Cheah S.;Wright T.;Cerdeira M. P.;McQuillan P.;Richardson M.;Liem H.;Spillane J.;Yacob M.;Albadawi F.;Thorpe T.;Dingle A.;Cabalag C.;Loi K.;Fisher O. M.;Ward S.;Read M.;Johnson M.;Bassari R.;Bui H.;Cecconello;Raa S.;Da Rocha J. R. M.;Lopes L. R.;Tercioti V.;Jds C.;Ferrer J. A. P.;Buduhan G.;Tan L.;Srinathan S.;Shea P.;Yeung J.;Allison F.;Carroll P.;Vargas-Barato F.;Gonzalez F.;Ortega J.;Nino-Torres L.;Beltran-Garcia T. C.;Castilla L.;Pineda M.;Bastidas A.;Gomez-Mayorga J.;Cortes N.;Cetares C.;Caceres S.;Duarte S.;Pazdro A.;Snajdauf M.;Faltova H.;Sevcikova M.;Mortensen P. B.;Katballe N.;Ingemann T.;Kruhlikava M. B.;Ainswort A. P.;Stilling N. M.;Eckardt J.;Holm J.;Thorsteinsson M.;Siemsen M.;Brandt B.;Nega B.;Teferra E.;Tizazu A.;Kauppila J. H.;Koivukangas V.;Merilainen S.;Gruetzmann R.;Krautz C.;Weber G.;Golcher H.;Emons G.;Azizian A.;Ebeling M.;Niebisch S.;Kreuser N.;Albanese G.;Hesse J.;Volovnik L.;Boecher U.;Reeh M.;Triantafyllou S.;Schizas D.;Michalinos A.;Balli E.;Mpoura M.;Charalabopoulos A.;Manatakis D. K.;Balalis D.;Bolger J.;Baban C.;Mastrosimone A.;McAnena O.;Quinn A.;O Suilleabhain C. B.;Hennessy M. M.;Ivanovski;Khizer H.;Ravi N.;Donlon N.;Cervellera M.;Vaccari S.;Bianchini S.;Sartarelli L.;Asti E.;Bernardi D.;Merigliano S.;Provenzano L.;Scarpa M.;Saadeh L.;Salmaso B.;De Manzoni G.;Giacopuzzi S.;La Mendola R.;De Pasqual C. A.;Tsubosa Y.;Niihara M.;Irino T.;Makuuchi R.;Ishii K.;Mwachiro M.;Fekadu A.;Odera A.;Mwachiro E.;Alshehab D.;Ahmed H. A.;Shebani A. O.;Elhadi A.;Elnagar F. A.;Elnagar H. F.;Makkai-Popa S. T.;Wong L. F.;Tan Y. R.;Thannimalai S.;Ho C. A.;Pang W. S.;Tan J. H.;Hnl B.;Cortes-Gonzalez R.;Lagarde S. M.;Van Lanschot J. J. B.;Cords C.;Jansen W. A.;Martijnse I.;Matthijsen R.;Bouwense S.;Klarenbeek B.;Verstegen M.;Van Workum F.;Ruurda J. P.;Van Der Sluis P. C.;De Maat M.;Evenett N.;Johnston P.;Patel R.;MacCormick A.;Young M.;Smith B.;Ekwunife C.;Memon A. H.;Shaikh K.;Wajid A.;Khalil N.;Haris M.;Mirza Z. U.;Sba Q.;Sarwar M. Z.;Shehzadi A.;Raza A.;Jhanzaib M. H.;Farmanali J.;Zakir Z.;Shakeel O.;Nasir;Khattak S.;Baig M.;Noor M. A.;Ahmed H. H.;Naeem A.;Pinho A. C.;Da Silva R.;Bernardes A.;Campos J. C.;Matos H.;Braga T.;Monteiro C.;Ramos P.;Cabral F.;Gomes M. P.;Martins P. C.;Correia A. M.;Videira J. F.;Ciuce C.;Drasovean R.;Apostu R.;Ciuce C.;Paitici S.;Racu A. E.;Obleaga C. V.;Beuran M.;Stoica B.;Negoita C. C.;Cordos;Birla R. D.;Predescu D.;Hoara P. A.;Tomsa R.;Shneider;Agasiev M.;Ganjara;Gunjic D.;Veselinovic M.;Babic T.;Chin T. S.;Shabbir A.;Kim G.;Crnjac A.;Samo H.;Diez Del Val;Leturio S.;Ramon J. M.;Dal Cero M.;Rifa S.;Rico M.;Pagan Pomar A.;Martinez Corcoles J. A.;Rodicio Miravalles J. L.;Pais S. A.;Turienzo S. A.;Alvarez L. S.;Campos P. V.;Rendo A. G.;Garcia S. S.;Epg S.;Martinez E. T.;Fernandez Diaz M. J.;Magadan Alvarez C.;Martin C.;Diaz Lopez C.;Rosat Rodrigo A.;Perez Sanchez L. E.;Bailon Cuadrado M.;Tinoco Carrasco C.;Choolani Bhojwani E.;Sanchez D. P.;Ahmed M. E.;Dzhendov T.;Lindberg F.;Rutegard M.;Sundbom M.;Mickael C.;Colucci N.;Schnider A.;Er S.;Kurnaz E.;Turkyilmaz S.;Turkyilmaz A.;Yildirim R.;Baki B. E.;Akkapulu N.;Karahan O.;Damburaci N.;Hardwick R.;Safranek P.;Sujendran;Bennett J.;Afzal Z.;Shrotri M.;Chan B.;Exarchou K.;Gilbert T.;Amalesh T.;Mukherjee D.;Mukherjee S.;Wiggins T. H.;Kennedy R.;McCain S.;Harris A.;Dobson G.;Davies N.;Wilson I.;Mayo D.;Bennett D.;Young R.;Manby P.;Blencowe N.;Schiller M.;Byrne B.;Mitton D.;Wong V.;Elshaer A.;Cowen M.;Menon;Tan L. C.;McLaughlin E.;Koshy R.;Sharp C.;Brewer H.;Das N.;Cox M.;Al Khyatt W.;Worku D.;Iqbal R.;Walls L.;McGregor R.;Fullarton G.;MacDonald A.;MacKay C.;Craig C.;Dwerryhouse S.;Hornby S.;Jaunoo S.;Wadley M.;Baker C.;Saad M.;Kelly M.;Davies A.;Di Maggio F.;McKay S.;Mistry P.;Singhal R.;Tucker O.;Kapoulas S.;Powell-Brett S.;Davis P.;Bromley G.;Watson L.;Verma R.;Ward J.;Shetty V.;Ball C.;Pursnani K.;Sarela A.;Sue Ling H.;Mehta S.;Hayden J.;To N.;Palser T.;Hunter D.;Supramaniam K.;Butt Z.;Ahmed A.;Kumar S.;Chaudry A.;Moussa O.;Kordzadeh A.;Wilson M. L. B.;Patil P.;Noaman;Willem J.;Bouras G.;Evans R.;Singh M.;Warrilow H.;Ahmad A.;Tewari N.;Yanni F.;Couch J.;Theophilidou E.;Reilly J. J.;Singh P.;Van Boxel G.;Akbari K.;Zanotti D.;Sgromo B.;Sanders G.;Wheatley T.;Ariyarathenam A.;Reece-Smith A.;Humphreys L.;Choh C.;Carter N.;Knight B.;Pucher P.;Athanasiou A.;Mohamed;Tan B.;Abdulrahman M.;Vickers J.;Akhtar K.;Chaparala R.;Brown R.;Alasmar M. M. A.;Ackroyd R.;Patel K.;Tamhankar A.;Wyman A.;Walker R.;Grace B.;Abbassi N.;Slim N.;Ioannidi L.;Blackshaw G.;Havard T.;Escofet X.;Powell A.;Owera A.;Rashid F.;Jambulingam P.;Padickakudi J.;Ben-Younes H.;McCormack K.;Makey I. A.;Karush M. K.;Seder C. W.;Liptay M. J.;Chmielewski G.;Rosato E. L.;Berger A. C.;Zheng R.;Okolo E.;Singh A.;Scott C. D.;Weyant M. J.;Mitchell J. D.
2023-01-01
Abstract
Objective: This study aimed to compare the postoperative and pathological outcomes between carboplatin, paclitaxel, radiotherapy (CROSS) and 5-FU, leucovorine, oxaliplatin and docetaxel (FLOT) in esophageal adenocarcinoma (EAC) patients from an international, multicenter cohort. Summary of Background Data: Ongoing debate exists around optimum approach to locally advanced EAC, with proponents for perioperative chemotherapy, such as FLOT, or multimodal therapy, in particular the CROSS regimen. Methods: Patients undergoing CROSS (n = 350) and FLOT (n = 368), followed by curative esophagectomy for EAC were identified from the Oesophagogastric Anastomosis Audit. Results: The 90-day mortality was higher after CROSS than FLOT (5% vs 1%, P = 0.005), even on adjusted analyses [odds ratio (OR): 3.97, confidence interval (CI)95%: 1.34-13.67]. Postoperative mortality in CROSS were related to higher pulmonary (74% vs 60%) and cardiac complications (42% vs 20%) compared to FLOT. CROSS was associated with higher pathologic complete response (pCR) rates (18% vs 10%, P = 0.004) and margin-negative resections (93% vs 76%, P < 0.001) compared with FLOT. On adjusted analyses, CROSS was associated with higher pCR rates (OR: 2.05, CI95%: 1.26-3.34) and margin-negative resections (OR: 4.55, CI95%: 2.70-7.69) compared to FLOT. Conclusions: This study provides real-world data CROSS was associated with higher 90-day mortality than FLOT, related to cardio-pulmonary complications with CROSS. These warrant a further review into causes and mechanisms in selected patients, and at minimum suggest the need for strict radiation therapy quality assurance. Research into impact of higher pCR rates and R0 resections with CROSS compared to FLOT on long-term survival is needed.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/627085
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
