ArticleCancers2025
Esophagectomy Versus Active Surveillance After Complete Response in Locally Advanced Esophageal Cancer: Retrospective Analysis.
Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Clinicopathological Factors Influencing Survival After Trimodality Treatment in Non-Metastatic Esophageal Cancer: A Retrospective Single-Center Study.Journal of clinical medicine · 2026Article
- Non-Operative Management of Esophageal Cancer with Complete Clinical Response After Neoadjuvant Therapy: Current Status and Future Directions.Journal of personalized medicine · 2026Review
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9 authors.
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Abstract
BACKGROUND/
objectivesEsophageal cancer (EC) remains highly lethal. The standard management of locally advanced disease includes neoadjuvant chemoradiotherapy (nCRT) followed by surgery. However, the role of esophagectomy in patients achieving clinical complete response (cCR) after nCRT remains uncertain.
methodsWe conducted a retrospective study at the Davidoff Cancer Center, Rabin Medical Center (2013-2023). Patients with thoracic EC (adenocarcinoma and squamous cell carcinoma) stage cT2-4a, N+, M0 who received nCRT (cisplatin/5-FU or CROSS regimen with 41.4-50.4 Gy) were included. Patients with cCR, defined by negative biopsies, endoscopic ultrasound, and PET-CT, were managed with surgery or surveillance. Survival was analyzed using Kaplan-Meier and Cox regression.
resultsOf 252 patients treated with nCRT, 118 achieved cCR. Seventy underwent surgery, with 47% (33 patients) achieving pathological complete response (pCR), and 48 were managed with surveillance. Five-year overall survival (OS) was 48% with surveillance and 49% with surgery; disease-free survival (DFS) was 36% vs. 43%. No significant differences were observed in OS (HR = 0.75, 95% CI 0.47-1.26) or DFS (HR = 0.88, 95% CI 0.55-1.41). In patients ≤70 years, surgery conferred an OS and DFS benefit (HR = 0.44,
conclusionsIn younger patients (≤70 years), surgery yielded significant survival benefit, supporting its role as the preferred treatment. In patients >70 years, surveillance produced comparable or superior outcomes, suggesting deferral of surgery may avoid morbidity without compromising survival. Age-specific tailoring of management is essential.
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