title: Impact of Adjuvant Chemotherapy on Patients with Lymph Node-Positive Esophageal Cancer who are primarily Treated with Surgery.
abstract: BACKGROUND
  Whereas the optimal therapeutic strategy in node positive esophageal cancer primarily treated by surgery remains unknown, the study was designed to evaluate the impact of adjuvant chemotherapy on survival in such population.
  
  
  METHODS
  Among 2944 consecutive patients operated on for esophageal cancer between 2000 and 2010 in 30 European centers, patients with lymph node metastasis treated by adjuvant treatment (n = 178) were compared to patients who did not received adjuvant treatment (n = 378). Multivariable analyses and propensity score matching were used to compensate for differences in baseline characteristics.
  
  
  RESULTS
  After matching, patients were comparable between the two groups. When comparing adjuvant treatment and nonadjuvant treatment groups, there was no significant differences in 3-year overall (40.9 vs. 35.8 %, P = 0.560) and disease-free (33.9 vs. 28.5 %, P = 0.190) survivals. Locoregional recurrence was lower in the adjuvant treatment group (14.4 vs. 30.9 %, P = 0.012). In the adjuvant treatment group, 94 patients received chemotherapy and 84 chemoradiotherapy, without significant survival benefit over chemoradiotherapy compared with chemotherapy alone (P = 0.280). Predictive factors of overall survival were age ≥60 years, ASA III-IV score, and pN+ classification. No survival benefit was observed according to histological subtype or occurrence of postoperative complications.
  
  
  CONCLUSIONS
  Adjuvant chemo(radio)therapy did not offer survival benefit in lymph node-positive esophageal cancer patients primarily treated with surgery.
authors.affiliation: Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pasquer
authors.affiliation: Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Regional University Hospital Center, Place de Verdun, Lille Cedex, France.|North of France University, Lille Cedex, France.|Inserm, UMR S-1172, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis," JPARC, Lille Cedex, France.|SIRIC OncoLille, Lille Cedex, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Gronnier
authors.affiliation: SIRIC OncoLille, Lille Cedex, France.|Department of Pathology, Lille University Hospital, Lille Cedex, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Renaud
authors.affiliation: SIRIC OncoLille, Lille Cedex, France.|Department of Biostatistics, University Hospital, Lille Cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.affiliation: Cavale Blanche University Hospital, Brest, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Théreaux
authors.affiliation: Purpan University Hospital, Toulouse, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Carrere
authors.affiliation: Estaing University Hospital, Clermont-Ferrand, France.
authors.forename: Johan
authors.initials: J
authors.lastname: Gagniere
authors.affiliation: Pontchaillou University Hospital, Rennes, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Meunier
authors.affiliation: Haut-Levêque University Hospital, Bordeaux, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Collet
authors.affiliation: Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Regional University Hospital Center, Place de Verdun, Lille Cedex, France. christophe.mariette@chru-lille.fr.|North of France University, Lille Cedex, France. christophe.mariette@chru-lille.fr.|Inserm, UMR S-1172, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis," JPARC, Lille Cedex, France. christophe.mariette@chru-lille.fr.|SIRIC OncoLille, Lille Cedex, France. christophe.mariette@chru-lille.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariette
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate