Upper GI 2017

3/28/2017

61

TheRoyalMarsden

Pathology

Conclusions

Data

CF

ECX

Important factors

n

% n

% P-value

Mandard TRG

1-3

43

93

<0.001

15%

32%

Longitudinal margin

4-5

244

194

85%

68%

Nodal dissection

total number harvested thoracic and abdominal nodes

Unavailable 99

75

R0 resection

Yes

211

222

0.058

59%

67%

Similar morbidity and mortality

No

144

111

41%

33%

Unavailable 32

29

Selection based on patient factors

• 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

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

TheRoyalMarsden

Health Related Quality of Life after Surgery for Junctional Cancer

Overall survival

1.00

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%)

CF

ECX

63 patients

20 Ext TG 43 TTO

0.75

Better baseline scores for TTO – fitter group

0.50

6/12 HQRL lower scores after TTO Role and Social Function Global Quality of Life Fatigue

0.25

Proportion surviving

0.00

0

1

2

3

4

5

6

7

8

Time from randomisation (Years)

446 343 229 172 124 91 70 45 23 ECX 451 345 227 167 121 71 46 21 13 CF At risk

Barbour et al 2008, BJS 95: 80-4

Alderson,Cunninghamet al ASCO 2015

11