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X. Shun
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P1.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 224)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.08-030 - Increasing the Interval between Neoadjuvant Chemoradiotherapy and Surgery in Esophageal Cancer. A Meta-Analysis of Published Studies (ID 2472)
09:30 - 09:30 | Author(s): X. Shun
- Abstract
Background:
Neoadjuvant chemordiotherapy followed by surgery was the most common approach for patients with resectable esophageal cancer. Operation was performed within 2 to 8 weeks after nCRT were completed. The aim of this meta-analysis was to clarify whether a longer interval between the end of neoadjuvant chemoradiotherapy (nCRT) and surgery was associated with a better overall survival in esophageal cancer.
Methods:
We performed a systematic literature search in MEDLINE, EMBASE, Cochrane Central Register of Contralled Trials (CENTRAL/CCTR), Clinical Trials from January 2000 to December 2014. Eligible studies were prospective or retrospective studies of esophageal cancer that assessed the effects of intervals longer or shorter than 7 to 8 weeks between the end of nCRT and surgery. The primary endpoint was the overall survival (OS) and pathologic complete response (pCR). Secondary endpoints were anastomotic leak, R0 resection and postoperative mortality rate. A meta-analysis was performed to estimate odds ratios (ORs) , using the fixed- or random-effects model, with review manager 5.2.
Results:
Five studies met the eligibility requirements, including 1016 patients, with 520 in the shorter interval group (≦7~8 weeks) and 496 in the longer interval group (＞7～8 weeks). The results of our meta-analysis showed that the longer interval between nCRT and surgery may be at a disadvantage in 2-year overall survival (OR =1.40 ,95% CI: 1.09–1.80, P=0.010) and R0 resection rate (OR =1.71, 95%CI:1.14-2.22, P=0.009 ). The pCR, anastomotic leak rate and postoperative morbidity were similar in the two groups.
Conclusion:
A longer waiting interval (more than the classical 6–8 weeks) from the end of preoperative CRT is not an increases the rate of pCR in esophageal cancer, with similar anastomotic leak rate and postoperative mortality rates. However, the longer interval between nCRT and surgery may be at a disadvantage in the long-term overall survival, thus it may be reasonable to perform surgery for patients at the esrliest opportunity after adequate recovery form nCRT, especially, who have clinical pCR. These results should be validated prospectively in a randomized trial.
