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TheRoyalMarsden
Conclusions
Important factors
Longitudinal margin
Nodal dissection
total number harvested
thoracic and abdominal nodes
Similar morbidity and mortality
Selection based on patient factors
61
Pathology
Data
CF
ECX
n
% n
% P-value
Mandard
TRG
1-3
43
15%
93
32%
<0.001
4-5
244
85%
194
68%
Unavailable 99
75
R0 resection
Yes
211
59%
222
67%
0.058
No
144
41%
111
33%
Unavailable 32
29
•
Mandard grade 1 rate was 9 (3%) CF vs 32 (11%) ECX.
•
A central pathologyreview of all patients is currently ongoing.
Alderson,Cunninghamet al ASCO 2015
TheRoyalMarsden
CROSS Trial
Trial Design
Resectable carcinoma of the
oesophagus
RANDOMISE
CRT
Chemo radiotherapy
(Carboplatin, paclitaxel,
41.4 Gy)
and surgery
S
Surgery alone
Van Hagen et al NEJM 2012;366:2074-84
CROSS Trial
TheRoyalMarsden
Health Related Quality of Life
after Surgery for Junctional Cancer
63 patients
20 Ext TG
43 TTO
Better baseline scores for TTO – fitter group
6/12 HQRL lower scores after TTO
Role and Social Function
Global Quality of Life
Fatigue
Barbour et al 2008, BJS 95: 80-4
Overall survival
Median survival (95% CI)
CF
2.02 (1.80,2.38)
ECX
2.15 (1.93,2.53)
HR
0.92 (0.79,1.08)
P-value
0.8582
3-year survival (95% CI)
CF
39% (35%, 44%)
ECX
42% (37%, 46%)
0.00
0.25
0.50
0.75
1.00
Proportion surviving
446 343 229 172 124 91 70 45 23
ECX
451 345 227 167 121 71 46 21 13
CF
At risk
0
1
2
3
4
5
6
7
8
Time from randomisation (Years)
CF
ECX
Alderson,Cunninghamet al ASCO 2015