title: Recurrence pattern in patients with a pathologically complete response after neoadjuvant chemoradiotherapy and surgery for oesophageal cancer.
abstract: BACKGROUND
  Little is known about recurrence patterns in patients with a pathologically complete response (pCR) or an incomplete response after neoadjuvant chemoradiotherapy (CRT) followed by resection for oesophageal cancer. This study was performed to determine the pattern of recurrence in patients with a pCR after neoadjuvant CRT followed by surgery.
  
  
  METHODS
  All patients who received neoadjuvant CRT followed by oesophagectomy between 1993 and 2009 were identified from a database, and categorized according to pathological tumour response. Recurrences were classified as locoregional or distant.
  
  
  RESULTS
  One hundred and eighty-eight patients were included. Median potential follow-up was 71·6 months. A pCR was achieved in 62 (33·0 per cent) of 188 patients. Recurrence developed in 24 (39 per cent) of 62 patients with a pCR and 70 (55·6 per cent) of 126 without a pCR (P = 0·044). Locoregional recurrence with or without synchronous distant metastases occurred in eight patients (13 per cent) in the pCR group and 31 (24·6 per cent) in the non-pCR group (P = 0·095). Locoregional recurrences without synchronous distant metastases occurred four (6 per cent) and ten (7·9 per cent) patients respectively (P = 0·945). The overall 5-year survival rate was significantly higher in the pCR group than in the non-pCR group (52 versus 33·9 per cent respectively; P = 0·019).
  
  
  CONCLUSIONS
  Of patients with a pCR, 13 per cent still developed a locoregional recurrence. Although pCR is more favourable for survival, it is not synonymous with cure or complete locoregional disease control.
authors.affiliation: Department of Surgery, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. p.vanhagen@erasmusmc.nl
authors.forename: P
authors.initials: P
authors.lastname: van Hagen
authors.forename: B P L
authors.initials: BP
authors.lastname: Wijnhoven
authors.forename: P
authors.initials: P
authors.lastname: Nafteux
authors.forename: J
authors.initials: J
authors.lastname: Moons
authors.forename: K
authors.initials: K
authors.lastname: Haustermans
authors.forename: G
authors.initials: G
authors.lastname: De Hertogh
authors.forename: J J B
authors.initials: JJ
authors.lastname: van Lanschot
authors.forename: T
authors.initials: T
authors.lastname: Lerut
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011446:Prospective Studies