When East Meets West, Understanding Is a 2-Way Street

Mené en Chine sur 451 patients atteints d'un carcinome épidermoïde de l'oesophage localement avancé (âge moyen : 56,5 ans ; 81 % d'hommes ; durée médiane de suivi : 53,5 mois), cet essai randomisé multicentrique de phase III évalue l'efficacité, du point de vue de la survie globale, d'un traitement associant une chimioradiothérapie néoadjuvante et une intervention chirurgicale par rapport une intervention chirurgicale seule

Résumé en anglais

The 5-year outcomes of the Neoadjuvant Chemoradiotherapy for Esophageal Cancer 5010 (NEOCRTEC5010) trial, the largest multi-institutional trial to our knowledge to compare neoadjuvant chemoradiotherapy (NCRT) followed by surgery with surgery alone for patients with esophageal squamous cell carcinoma (ESCC), were reported by Yang and colleagues in this issue of JAMA Surgery. The authors previously reported that 83% of patients in this study who were randomized to receive NCRT successfully underwent surgical resection, with the rate of R0 resection increasing from 91.2% without NCRT to 98.4% with NCRT. Moreover, with the exception of postoperative atrial fibrillation, postoperative complications, anastomotic leak rates, and 30-day mortality rates were equivalent between the 2 groups. In the follow-up study, the authors report an absolute benefit in 5-year disease-free survival of 20.6% and 5-year overall survival of 10.8%. Furthermore, rates of locoregional and distant recurrence were both significantly lower in the NCRT group.