Abstract Background Adenocarcinoma of the esophagus remains a highly lethal malignancy with limited treatment options. Currently, neoadjuvant chemoradiotherapy (nCRT) (CROSS) followed by surgery is a standard treatment; however, definitive CRT (dCRT) is also offered as curative option. Limited data exist regarding its efficacy, necessitating further evaluation of survival outcomes. Methods Patients diagnosed with locoregional advanced adenocarcinoma of the esophagus or esophagogastric junction (EGJ) who (nearly) completed dCRT (50.4 Gy) were included from the nationwide Netherlands Cancer Registry (2015–2022). Follow-up data were available until December 31, 2023. Overall survival (OS) was analyzed, and a multivariable Cox regression analysis was performed to evaluate prognostic factors. Progression-free survival (PFS) was analyzed and defined as the absence of locoregional or distant recurrence or death. Results A total of 872 patients were included, predominantly male (80%), with 50% classified as intestinal type and 70% as WHO performance scale 0–1. Median overall survival (OS) was 18.9 months (95% CI: 17.8–20.9), with a 3-year survival rate of 25% and a 5-year estimate of 13.5%. Prognostic factors included gender (female vs. male, HR 0.70, 95% CI: 0.57–0.86), cT-category (HR 1.33, 95% CI: 1.11–1.60), cN-category (HR 1.23, 95% CI: 1.04–1.48), tumor differentiation grade (HR 1.37, 95% CI:1.13–1.66), and location (HR 1.34, 95% CI: 1.04–1.72). Median progression-free survival was 11.2 months (95% CI: 8.8–13.4). Conclusion Overall survival and progression-free survival in patients with locoregional advanced adenocarcinoma of the esophagus and EGJ who (nearly) completed dCRT were poor. These outcomes highlight the need for caution when considering dCRT as a curative treatment option.
Panday et al. (Fri,) studied this question.
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