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An International Mu...
An International Multicenter Study Exploring Whether Surveillance After Esophageal Cancer Surgery Impacts Oncological and Quality of Life Outcomes (ENSURE).
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Elliott, Jessie A (författare)
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Markar, Sheraz R (författare)
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- Klevebro, Fredrik (författare)
- Karolinska Institutet
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Johar, Asif (författare)
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Goense, Lucas (författare)
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- Lagergren, Pernilla (författare)
- Karolinska Institutet
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Zaninotto, Giovanni (författare)
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van Hillegersberg, Richard (författare)
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van Berge Henegouwen, Mark I (författare)
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- Nilsson, Magnus (författare)
- Karolinska Institutet
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Hanna, George B (författare)
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Reynolds, John V (författare)
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(creator_code:org_t)
- 2022
- 2022
- Engelska.
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Ingår i: Annals of Surgery. - 0003-4932 .- 1528-1140.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
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- OBJECTIVE: To determine the impact of surveillance on recurrence pattern, treatment, survival and health-related quality-of-life (HRQL) following curative-intent resection for esophageal cancer.SUMMARY BACKGROUND DATA: Although therapies for recurrent esophageal cancer may impact survival and HRQL, surveillance protocols after primary curative treatment are varied and inconsistent, reflecting a lack of evidence.METHODS: European iNvestigation of SUrveillance after Resection for Esophageal cancer was an international multicenter study of consecutive patients undergoing surgery for esophageal and esophagogastric junction cancers (2009-2015) across 20 centers (NCT03461341). Intensive surveillance (IS) was defined as annual computed tomography for 3 years postoperatively. The primary outcome measure was overall survival (OS), secondary outcomes included treatment, disease-specific survival, recurrence pattern, and HRQL. Multivariable linear, logistic, and Cox proportional hazards regression analyses were performed.RESULTS: Four thousand six hundred eighty-two patients were studied (72.6% adenocarcinoma, 69.1% neoadjuvant therapy, 45.5% IS). At median followup 60 months, 47.5% developed recurrence, oligometastatic in 39%. IS was associated with reduced symptomatic recurrence (OR 0.17 [0.12-0.25]) and increased tumor-directed therapy (OR 2.09 [1.58-2.77]). After adjusting for confounders, no OS benefit was observed among all patients (HR 1.01 [0.89-1.13]), but OS was improved following IS for those who underwent surgery alone (HR 0.60 [0.47-0.78]) and those with lower pathological (y)pT stages (Tis-2, HR 0.72 [0.58-0.89]). IS was associated with greater anxiety ( P =0.016), but similar overall HRQL.CONCLUSIONS: IS was associated with improved oncologic outcome in select cohorts, specifically patients with early-stage disease at presentation or favorable pathological stage post neoadjuvant therapy. This may inform guideline development, and enhance shared decision-making, at a time when therapeutic options for recurrence are expanding.
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Till lärosätets databas
- Av författaren/redakt...
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Elliott, Jessie ...
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Markar, Sheraz R
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Klevebro, Fredri ...
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Johar, Asif
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Goense, Lucas
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Lagergren, Perni ...
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visa fler...
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Zaninotto, Giova ...
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van Hillegersber ...
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van Berge Henego ...
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Nilsson, Magnus
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Hanna, George B
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Reynolds, John V
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visa färre...
- Artiklar i publikationen
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Annals of Surger ...
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet