ArticleAnnals of surgical oncology2026
Definitive Chemoradiotherapy for Adenocarcinoma of the Esophagus or Esophago-Gastric Junction: A Dutch Population-Based Cohort Study.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLocally advanced esophageal adenocarcinoma has a poor prognosis and limited treatment options when surgery is not possible or desired. Although definitive chemoradiotherapy (dCRT) is currently administered as a curatively intended treatment, limited data exist regarding its efficacy for patients with adenocarcinoma of the esophagus, necessitating further evaluation of survival outcomes.
methodsPatients with a diagnosis of adenocarcinoma of the esophagus or esophago-gastric junction who had undergone dCRT (defined as a radiation dose of > 41.4 Gy and ≤ 50.4 Gy, respectively) were identified from the nationwide Netherlands Cancer Registry (2015-2022). Overall survival (OS) was analyzed, and multivariable Cox regression analysis was performed to evaluate prognostic factors. Progression-free survival (PFS) was estimated for the subgroup of patients with detailed follow-up data from 2015 to 2017.
resultsThe study analyzed 926 patients, including 263 patients with data on recurrence patterns. Of these patients, 77% had a diagnosis of stage III/IVa disease, and 72% had a WHO performance status of 0 to 1. The 90-day mortality rate was 7.1%. The median OS was 19.6 months (95% confidence interval [CI], 18.6-21.2 months), and the 3-year OS was 28%. The median PFS was 12.1 months (95% CI, 9.7-14.0 months). Clinical T3-T4 category, cN+ category, WHO performance status, and tumor length were linked to worse survival, although the multivariable model had limited discriminatory power.
conclusionReal-world OS and PFS for patients with adenocarcinoma of the esophagus or esophago-gastric junction who received dCRT were poor, and 90-day mortality was substantial. These outcomes highlight the need for optimal patient selection, well-informed shared decision-making, and the development of improved treatment strategies.
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