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Sökning: id:"swepub:oai:DiVA.org:uu-489605" > An International Mu...

  • Elliott, Jessie A (författare)

An International Multicenter Study Exploring Whether Surveillance After Esophageal Cancer Surgery Impacts Oncological and Quality of Life Outcomes (ENSURE).

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • 2022
  • 2022
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-489605
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-489605URI
  • https://doi.org/10.1097/SLA.0000000000005378DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:152893760URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • 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.

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Markar, Sheraz R (författare)
  • Klevebro, FredrikKarolinska Institutet (författare)
  • Johar, Asif (författare)
  • Goense, Lucas (författare)
  • Lagergren, PernillaKarolinska Institutet (författare)
  • Zaninotto, Giovanni (författare)
  • van Hillegersberg, Richard (författare)
  • van Berge Henegouwen, Mark I (författare)
  • Nilsson, MagnusKarolinska Institutet (författare)
  • Hanna, George B (författare)
  • Reynolds, John V (författare)
  • Karolinska Institutet (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Annals of Surgery0003-49321528-1140

Internetlänk

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