Evidence map›Paper›PMID 27435280›Full record

Trial reportBMC cancer2016

ESOPEC: prospective randomized controlled multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (NCT02509286).

Jens Hoeppner, Florian Lordick, Thomas Brunner, Torben Glatz, Peter Bronsert, Nadine Röthling, Claudia Schmoor, Dietmar Lorenz, Christian Ell, Ulrich T Hopt and 1 more

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02509286 (Perioperative Chemotherapy), which is not on this map. Cited by 197 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
197citing papers in PubMed, 8 pooled it
21.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02509286 phase3unknown statusnot on this map

Perioperative Chemotherapy (FLOT Protocol) Compared To Neoadjuvant Chemoradiation (CROSS Protocol) in Patients With Adenocarcinoma of the Esophagus

TypeinterventionalSponsorUniversity Hospital Schleswig-HolsteinRan2016 to 2024Enrolled438ConditionsEsophageal Adenocarcinoma (UICC TNM7), Adenocarcinoma of the Esophagogastric JunctionArms5-Fluorouracil, Leucovorin, Oxaliplatin, Docetaxel, Carboplatin
3 · Its place in the literature

Who cites it

197 citing papers in PubMed, 8 syntheses or guidelines pooled it, 344 citations in OpenAlex.

  1. Pooled it
  2. ISDE guidelines on the management of cT2N0 esophageal cancer.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026
    Guideline
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  5. SEOM-GEMCAD-TTD clinical guideline for the diagnosis and treatment of gastric cancer (2023).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024
    Guideline
  6. Evaluation of tumor regression by neoadjuvant chemotherapy regimens for esophageal adenocarcinoma: a systematic review and meta-analysis.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023
    Pooled it
  7. [Surgical treatment of esophageal cancer-Indicators for quality in diagnostics and treatment].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021
    Pooled it
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137 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Jens HoeppnerDepartment of General and Visceral Surgery, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. jens.hoeppner@uniklinik-freiburg.de.
Florian LordickUniversity Cancer Center Leipzig (UCCL), University Medicine Leipzig, Leipzig, Germany.
Thomas BrunnerDepartment of Radiation Oncology, Medical Center - University of Freiburg, Freiburg, Germany.
Torben GlatzDepartment of General and Visceral Surgery, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Peter BronsertInstitute for Surgical Pathology, Medical Center - University of Freiburg, Freiburg, Germany.
Nadine RöthlingClinical Trials Center, Medical Center - University of Freiburg, Freiburg, Germany.
Claudia SchmoorClinical Trials Center, Medical Center - University of Freiburg, Freiburg, Germany.
Dietmar LorenzDepartment of Surgery, Sana Medical Center Offenbach, Offenbach, Germany.
Christian EllDepartment of Gastroenterology, Sana Medical Center Offenbach, Offenbach, Germany.
Ulrich T HoptDepartment of General and Visceral Surgery, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
J Rüdiger SiewertMedical Center, University of Freiburg, Freiburg, Germany.
University Medical Center Freiburg · DEUniversity of Freiburg · DESana Klinikum Offenbach · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent randomized controlled trials comparing neoadjuvant chemoradiation plus surgery or perioperative chemotherapy plus surgery with surgery alone showed significant survival benefits for combined modality treatment of patients with localized esophageal adenocarcinoma. However, head-to-head comparisons of neoadjuvant chemoradiation and perioperative chemotherapy applying contemporary treatment protocols are lacking. The present trial was initiated to obtain valid information whether neoadjuvant chemoradiation or perioperative chemotherapy yields better survival in the treatment of localized esophageal adenocarcinoma. METHODS/

designThe ESOPEC trial is an investigator-initiated multicenter prospective randomized controlled two-arm trial, comparing the efficacy of neoadjuvant chemoradiation (CROSS protocol: 41.4Gy plus carboplatin/paclitaxel) followed by surgery versus perioperative chemotherapy and surgery (FLOT protocol: 5-FU/leucovorin/oxaliplatin/docetaxel) for the curative treatment of localized esophageal adenocarcinoma. Patients with cT1cN + cM0 and cT2-4acNxcM0 esophageal and junctional adenocarcinoma are eligible. The trial aims to include 438 participants who are centrally randomized to one of the two treatment groups in a 1:1 ratio stratified by N-stage and study site. The primary endpoint of the trial is overall survival assessed with a minimum follow-up of 36 months. Secondary objectives are progression-free survival, recurrence-free survival, site of failure, postoperative morbidity and mortality, duration of hospitalization as well as quality of life. DISCUSSION: The ESOPEC trial compares perioperative chemotherapy according to the FLOT protocol to neoadjuvant chemoradiation according to the CROSS protocol in multimodal treatment of non-metastasized recectable adenocarcinoma of the esophagus and the gastroesophageal junction. The goal of the trial is identify the superior protocol with regard to patient survival, treatment morbidity and quality of life.

trial registrationNCT02509286 (July 22, 2015).

Indexed as

AdenocarcinomaAdultAgedAntineoplastic Combined Chemotherapy ProtocolsChemoradiotherapyDisease-Free SurvivalDrug TherapyEsophageal NeoplasmsEsophagusFemaleHumansMaleMiddle AgedNeoadjuvant TherapyNeoplasm Recurrence, LocalProspective StudiesAdenocarcinomaEsophageal cancerNeoadjuvant chemoradiationPerioperative chemotherapy

Identifiers

PMID27435280
PMCPMC4952147
OpenAlexW2497800384

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.