Prognostic value of Mandard score and nodal status for recurrence patterns and survival after multimodal treatment of oesophageal adenocarcinoma-Reference-Cited by-同舟云学术

Prognostic value of Mandard score and nodal status for recurrence patterns and survival after multimodal treatment of oesophageal adenocarcinoma

Published:2024-01-31 Issue:2 Volume:111 Page:
ISSN:0007-1323
Container-title:British Journal of Surgery
language:en
Short-container-title:

Author:

Henckens Sofie P G¹²³^ORCID,Liu Dajia⁴⁵,Gisbertz Suzanne S¹²³,Kalff Marianne C¹²³^ORCID,Anderegg Maarten C J¹²³,Crull David⁶,Daams Freek⁷,van Dalsen Annette D⁸,Dekker Jan Willem T⁹,van Det Marc J⁶,van Duijvendijk Peter¹⁰,Eshuis Wietse J¹²³,Groenendijk Richard P R¹¹,Haveman Jan Willem¹²,van Hillegersberg Richard¹³^ORCID,Luyer Misha D P¹⁴^ORCID,Olthof Pim B⁹,Pierie Jean-Pierre E N¹⁵,Plat Victor D⁷^ORCID,Rosman Camiel¹⁶^ORCID,Ruurda Jelle P¹³,van Sandick Johanna W¹⁷,Sosef Meindert N¹⁸,Voeten Daan M¹²³,Vijgen Guy H E J¹⁹^ORCID,Bijlsma Maarten F²⁵²⁰,Meijer Sybren L²²¹,Hulshof Maarten C C M²²²,Oyarce Cesar⁵²⁰,Lagarde Sjoerd M¹⁹,van Laarhoven Hanneke W M²⁴,van Berge Henegouwen Mark I¹²³^ORCID, ,Baas Peter C,Bahadoer Renu R,Belt Eric J T,Brattinga Baukje,Claassen Linda,Ćosović Admira,Drost Manon,van Esser Stijn,Gaspersz Marcia P,Görgec Burak,Hartgrink Henk H,van der Harst Erwin,Heisterkamp Joos,Kelder Wendy,Kingma B Feike,Koemans Willem J,Kouwenhoven Ewout A,Lecot Frederik,van der Linden Philip P,Nieuwenhuijzen Grard A P,van Oijen Martijn G H,van der Peet Donald L,Pierik E G J M Robert,Polat Fatih,Scheer Rene,Slootmans Cettela A M,Sosef Odin V,de Steur Wobbe O,Stockmann Hein B A C,Stoop Fanny J,Vugts Guusje,Weeda Víola B,Wiezer Marinus J

Affiliation:

1. Department of Surgery, Amsterdam UMC, Location University of Amsterdam , Amsterdam , the Netherlands

2. Cancer Centre Amsterdam, Cancer Treatment and Quality of Life , Amsterdam , the Netherlands

3. Department of Gastroenterology and Hepatology, Amsterdam UMC, Location University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands

4. Department of Medical Oncology, Amsterdam UMC, Location University of Amsterdam , Amsterdam , the Netherlands

5. Centre for Experimental and Molecular Medicine, Laboratory for Experimental Oncology and Radiobiology, Amsterdam UMC, Location University of Amsterdam , Amsterdam , the Netherlands

6. Department of Surgery, Ziekenhuisgroep Twente , Almelo , the Netherlands

7. Department of Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam , Amsterdam , the Netherlands

8. Department of Surgery, Isala Klinieken , Zwolle , the Netherlands

9. Department of Surgery, Reinier de Graaf Groep , Delft , the Netherlands

10. Department of Surgery, Gelre Ziekenhuis , Apeldoorn , the Netherlands

11. Department of Surgery, IJsselland Ziekenhuis , Capelle aan den IJssel , the Netherlands

12. Department of Surgery, University Medical Centre Groningen, University of Groningen , Groningen , the Netherlands

13. Department of Surgery, UMC Utrecht , Utrecht , the Netherlands

14. Department of Surgery, Catharina Ziekenhuis , Eindhoven , the Netherlands

15. Department of Surgery, MC Leeuwarden , Leeuwarden , the Netherlands

16. Department of Surgery, Radboud University Medical Centre , Nijmegen , the Netherlands

17. Department of Surgery, Antoni van Leeuwenhoek Ziekenhuis , Amsterdam , the Netherlands

18. Department of Surgery, Zuyderland , Heerlen , the Netherlands

19. Department of Surgery, Erasmus Medical Centre , Rotterdam , the Netherlands

20. Oncode Institute , Amsterdam , the Netherlands

21. Department of Pathology, Amsterdam UMC, Location University of Amsterdam , Amsterdam , the Netherlands

22. Department of Radiotherapy, Amsterdam UMC, Location University of Amsterdam , Amsterdam , the Netherlands

Abstract

Abstract Background This study evaluated the association of pathological tumour response (tumour regression grade, TRG) and a novel scoring system, combining both TRG and nodal status (TRG-ypN score; TRG1-ypN0, TRG>1-ypN0, TRG1-ypN+ and TRG>1-ypN+), with recurrence patterns and survival after multimodal treatment of oesophageal adenocarcinoma. Methods This Dutch nationwide cohort study included patients treated with neoadjuvant chemoradiotherapy followed by oesophagectomy for distal oesophageal or gastro-oesophageal junctional adenocarcinoma between 2007 and 2016. The primary endpoint was the association of Mandard score and TRG-ypN score with recurrence patterns (rate, location, and time to recurrence). The secondary endpoint was overall survival. Results Among 2746 inclusions, recurrence rates increased with higher Mandard scores (TRG1 30.6%, TRG2 44.9%, TRG3 52.9%, TRG4 61.4%, TRG5 58.2%; P < 0.001). Among patients with recurrent disease, the distribution (locoregional versus distant) was the same for the different TRG groups. Patients with TRG1 developed more brain recurrences (17.7 versus 9.8%; P = 0.001) and had a longer mean overall survival (44 versus 35 months; P < 0.001) than those with TRG>1. The TRG>1-ypN+ group had the highest recurrence rate (64.9%) and worst overall survival (mean 27 months). Compared with the TRG>1-ypN0 group, patients with TRG1-ypN+ had a higher risk of recurrence (51.9 versus 39.6%; P < 0.001) and worse mean overall survival (33 versus 41 months; P < 0.001). Conclusion Improved tumour response to neoadjuvant therapy was associated with lower recurrence rates and higher overall survival rates. Among patients with recurrent disease, TRG1 was associated with a higher incidence of brain recurrence than TRG>1. Residual nodal disease influenced prognosis more negatively than residual disease at the primary tumour site.

Publisher

Oxford University Press (OUP)

Link

https://academic.oup.com/bjs/article-pdf/111/2/znae034/56743322/znae034.pdf