title: Multicentre study of neoadjuvant chemotherapy for stage I and II oesophageal cancer.
abstract: BACKGROUND
  The benefit of neoadjuvant chemotherapy (NCT) for early-stage oesophageal cancer is unknown. The aim of this study was to assess whether NCT improves the outcome of patients with stage I or II disease.
  
  
  METHODS
  Data were collected from 30 European centres from 2000 to 2010. Patients who received NCT for stage I or II oesophageal cancer were compared with patients who underwent primary surgery with regard to postoperative morbidity, mortality, and overall and disease-free survival. Propensity score matching was used to adjust for differences in baseline characteristics.
  
  
  RESULTS
  Of 1173 patients recruited (181 NCT, 992 primary surgery), 651 (55·5 per cent) had clinical stage I disease and 522 (44·5 per cent) had stage II disease. Comparisons of the NCT and primary surgery groups in the matched population (181 patients in each group) revealed in-hospital mortality rates of 4·4 and 5·5 per cent respectively (P = 0·660), R0 resection rates of 91·7 and 86·7 per cent (P = 0·338), 5-year overall survival rates of 47·7 and 38·6 per cent (hazard ratio (HR) 0·68, 95 per cent c.i. 0·49 to 0·93; P = 0·016), and 5-year disease-free survival rates of 44·9 and 36·1 per cent (HR 0·68, 0·50 to 0·93; P = 0·017).
  
  
  CONCLUSIONS
  NCT was associated with better overall and disease-free survival in patients with stage I or II oesophageal cancer, without increasing postoperative morbidity.
authors.affiliation: Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Bekkar
authors.affiliation: Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France.|North of France University, Lille, France.|Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1172, Team 5 'Mucins, epithelial differentiation and carcinogenesis', Jean-Pierre Aubert Research Centre, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Gronnier
authors.affiliation: Department of Pathology, Lille University Hospital, Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Renaud
authors.affiliation: Department of Biostatistics, Lille University Hospital, Lille, France.|Site de Recherche Intégré en Cancérologie OncoLille, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Duhamel
authors.affiliation: Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Pasquer
authors.affiliation: Cavale Blanche University Hospital, Brest, France.
authors.forename: J
authors.initials: J
authors.lastname: Théreaux
authors.affiliation: Estaing University Hospital, Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Gagnière
authors.affiliation: Pontchaillou University Hospital, Rennes, France.
authors.forename: B
authors.initials: B
authors.lastname: Meunier
authors.affiliation: Haut-Levêque University Hospital, Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Collet
authors.affiliation: Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France.|North of France University, Lille, France.|Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1172, Team 5 'Mucins, epithelial differentiation and carcinogenesis', Jean-Pierre Aubert Research Centre, Lille, France.|Site de Recherche Intégré en Cancérologie OncoLille, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Mariette
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology