Evidence map›Paper›PMID 32462769›Full record

ArticleJournal of surgical oncology2020

Should adenosquamous esophageal cancer be treated like adenocarcinoma or squamous cell carcinoma?

Adriana C Gamboa, Benjamin I Meyer, Jeffrey M Switchenko, Manali Rupji, Rachel M Lee, Michael K Turgeon, Maria C Russell, Kenneth Cardona, David A Kooby, Shishir K Maithel and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of surgical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.8field-weighted citation impact, top 15% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

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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 1 institution in 1 country.

Adriana C GamboaDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID https://orcid.org/0000-0002-5464-2178
Benjamin I MeyerDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Jeffrey M SwitchenkoDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Manali RupjiDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Rachel M LeeDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID https://orcid.org/0000-0003-2704-839X
Michael K TurgeonDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Maria C RussellDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID https://orcid.org/0000-0003-1584-6992
Kenneth CardonaDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID https://orcid.org/0000-0002-8200-3269
David A KoobyDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID https://orcid.org/0000-0001-8694-0455
Shishir K MaithelDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Mihir M ShahDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID https://orcid.org/0000-0002-4665-5534
Emory University · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
NCI NIH HHS P30 CA138292The Abraham J. & Phyllis Katz Foundation
6 · The paper itself

Abstract

backgroundEsophageal adenocarcinoma (AC) and squamous cell carcinoma (SCC) have distinct outcomes, treatment strategies, and response profiles to therapy. Adenosquamous carcinoma (ASC) is thought to behave more aggressively than each of its counterparts. The aim of this study is to determine ifASC is best managed as AC or SCC.

methodsNational Cancer Database (2004-2015) was queried for patients with nonmetastatic esophageal ASC. The analysis was stratified by clinical node-negative (cN0) or clinical node-positive (cN1-3). Treatment was categorized into chemoradiation alone, surgery alone, or preoperative chemoradiation followed by surgery. The primary outcome was 5-year overall survival (OS).

resultsAmong 352 patients, 43% were cN0 (n = 151), 57% were cN1-3 (n = 201) and 55% had chemoradiation alone (n = 194), 15% surgery alone (n = 53), and 30% preoperative chemoradiation (n = 105). Among patients who had preoperative chemoradiation, 20% had pathologic complete response (n = 17). For either cN0 or cN1-3, Charlson-Deyo Comorbidity Index did not differ among the treatment groups(all p > 0.05). On Kaplan-Meier analysis for cN0, treatment with surgery alone had comparable OS to preoperative chemoradiation (47% vs 34%; P = .5) and each had improved OS compared to chemoradiation alone (30%; P = .02; P = .06). On univariate analysis for cN0, clinical T category was not associated with OS. For cN1-3, however, preoperative chemoradiation was associated with improved OS when compared to chemoradiation alone or surgery alone (27% vs 19% vs 0%; P < .001). This persisted when accounting for age and clinical T category (hazard ratio: 0.45; P < .001).

conclusionEsophageal ASC behaves more like AC in response to chemoradiation and survival based on treatment modality. A complete response to chemoradiation is only 20% unlike what has been shown for SCC, where chemoradiation is an acceptable definitive therapy. Esophageal ASC should be managed more like AC.

Indexed as

AdenocarcinomaAgedCarcinoma, AdenosquamousChemoradiotherapyCombined Modality TherapyEsophageal NeoplasmsEsophageal Squamous Cell CarcinomaFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm StagingPreoperative CareRegistriesUnited Statesadenocarcinomaadenosquamous carcinomaesophageal canceresophageal surgerysquamous cell carcinoma

Identifiers

PMID32462769
PMCPMC7396283
OpenAlexW3030819846

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.