Kauppila, J., Wahlin, K., Lagergren, P., Lagergren, J. (2018) Neoadjuvant therapy in relation to lymphadenectomy and resection margins during surgery for oesophageal cancer. Scientific Reports, 8 (1), 446. doi:10.1038/s41598-017-18879-6
Neoadjuvant therapy in relation to lymphadenectomy and resection margins during surgery for oesophageal cancer
|Author:||Kauppila, Joonas H.1,2; Wahlin, Karl1; Lagergren, Pernilla3;|
1Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital
2Cancer and Translational Medicine Research Unit, Medical Research Center, University of Oulu and Oulu University Hospital
3Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital
4Division of Cancer Studies, King’s College London and Guy’s and St Thomas’ NHS Foundation Trust
|Online Access:||PDF Full Text (PDF, 1.1 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe201803286237
|Publish Date:|| 2018-03-28
Differences in lymph node yield and tumour-involved resection margins comparing neoadjuvant therapy plus surgery with surgery alone for oesophageal cancer are unclear. Patients who underwent oesophageal cancer surgery in Sweden in 1987–2010 were included. Patients treated with neoadjuvant therapy were compared with those who underwent surgery alone. Outcomes were the number of examined lymph nodes (main outcome), number metastatic lymph nodes, and resection margin status. Rate ratios (RRs) and 95% CIs of lymph node yield were calculated by Poisson regression, and odds ratios (ORs) and 95% CIs of resection margin status by multivariable logistic regression, both adjusted for confounders. Among 1818 patients, 587 (32%) had received neoadjuvant therapy and 1231 (68%) had not. Lymph node yield was lower in the neoadjuvant therapy group (median 6 versus 8; adjusted RR 0.75, 0.73–0.78). Fewer metastatic nodes were identified following neoadjuvant therapy (median 0 versus 1; adjusted RR 0.76, 0.69–0.84). Neoadjuvant therapy associated to decreased risk of tumour-involved resection margins when adjusted for confounders except T-stage (OR 0.52, 0.38–0.70), but the association did not remain after adjustment for T-stage (OR 0.91, 0.64–1.29). Neoadjuvant therapy seems to decrease the lymph node yield and decrease the risk of tumour-involved resection margins by shrinking primary tumour.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
This study was supported by grants from the Swedish Cancer Society (JL), Swedish Research Council (JL), Stockholm Cancer Society (PL), Sigrid Jusélius Foundation (JHK) and Orion Research Foundation (JHK).
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