10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial)

CROSS Study Grp; Ben M. Eyck; J. Jan B. van Lanschot; Maarten C. C. M. Hulshof; Berend J. van der Wilk; Joel Shapiro; Pieter van Hagen; Mark I. van Berge Henegouwen; Bas P. L. Wijnhoven; Hanneke W. M. van Laarhoven; Grard A. P. Nieuwenhuijzen; Geke A. P. Hospers; Johannes J. Bonenkamp; Miguel A. Cuesta; Reinoud J. B. Blaisse; Olivier R. Busch; Geert-Jan M. Creemers; Cornelis J. A. Punt; John Th. M. Plukker; Henk M. W. Verheul; Ernst J. Spillenaar Bilgen; Maurice J. C. van der Sangen; Tom Rozema; Fiebo J. W. ten Kate; Jannet C. Beukema; Anna H. M. Piet; Caroline M. van Rij; Janny G. Reinders; Hugo W. Tilanus; Ewout W. Steyerberg; Ate van der Gaast

10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial)

CROSS Study Grp, Ben M. Eyck, J. Jan B. van Lanschot, Maarten C. C. M. Hulshof, Berend J. van der Wilk, Joel Shapiro, Pieter van Hagen, Mark I. van Berge Henegouwen, Bas P. L. Wijnhoven, Hanneke W. M. van Laarhoven, Grard A. P. Nieuwenhuijzen, Geke A. P. Hospers, Johannes J. Bonenkamp, Miguel A. Cuesta, Reinoud J. B. Blaisse, Olivier R. Busch, Geert-Jan M. Creemers, Cornelis J. A. Punt, John Th. M. Plukker, Henk M. W. VerheulErnst J. Spillenaar Bilgen, Maurice J. C. van der Sangen, Tom Rozema, Fiebo J. W. ten Kate, Jannet C. Beukema, Anna H. M. Piet, Caroline M. van Rij, Janny G. Reinders, Hugo W. Tilanus, Ewout W. Steyerberg, Ate van der Gaast

Research output: Contribution to journal › Meeting Abstract › Academic

Abstract

Background: Neoadjuvant chemoradiotherapy according to the Chemo-
Radiotherapy for Oesophageal cancer followed by Surgery Study (CROSS)
has become a standard of care for patients with locally advanced resectable
esophageal or junctional cancer. However, the long-term benefits and
harms remain unclear.We aimed to assess the long-term outcomes of this
regimen.
Materials and Methods: From 2004 through 2008, 366 patients were
randomly assigned to either five weekly cycles of intravenous carboplatin
(area under the curve of 2 mg/mL/min) and paclitaxel (50 mg/m2 bodysurface
area) on days 1, 8,15, 22, and 29 with concurrent radiotherapy (41.4
Gy in 23 fractions, 5 days per week) followed by surgery, or surgery alone.
Follow-up data were collected through 2018. Overall survival was estimated
with the Kaplan-Meier method and compared with Cox regression
analyses. The effect beyond 5 years of follow-up was assessed by using
landmark analyses. Also, cause-specific mortality was estimated with cumulative
incidence functions and compared with Cox regression.
Results: The median follow-up was 147 months (IQR 134-157). Patients
who received neoadjuvant chemoradiotherapy had better overall survival
(HR 0.70, 95%CI 0.55-0.89), with 10-year overall survival of 38% (95%CI 31-
45) in the neoadjuvant chemoradiotherapy plus surgery arm and 25% (95%
CI 19-32) in the surgery alone arm. Landmark analyses showed that the
overall survival benefit that was gained in the first 5 years, persisted
beyond 5 years. The risk of death from esophageal cancer was lower for
patients who received neoadjuvant chemoradiotherapy plus surgery (HR
0.60, 95% CI 0.46-0.80), while death from other causes was comparable
between both study arms (HR 1.17, 95%CI 0.68-1.99).
Conclusions: The overall survival benefit of patients with locally advanced
resectable esophageal or esophagogastric junctional cancer who received
neoadjuvant chemoradiotherapy plus surgery according to the CROSS
regimen persists for at least 10 years, compared with surgery alone.

Original language	English
Pages (from-to)	S147-S147
Number of pages	1
Journal	Annals of Surgical Oncology
Volume	28
Issue number	SUPPL 1
Publication status	Published - Feb-2021

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CROSS Study Grp, Eyck, B. M., van Lanschot, J. J. B., Hulshof, M. C. C. M., van der Wilk, B. J., Shapiro, J., van Hagen, P., Henegouwen, M. I. V. B., Wijnhoven, B. P. L., van Laarhoven, H. W. M., Nieuwenhuijzen, G. A. P., Hospers, G. A. P., Bonenkamp, J. J., Cuesta, M. A., Blaisse, R. J. B., Busch, O. R., Creemers, G.-J. M., Punt, C. J. A., Plukker, J. T. M., ... van der Gaast, A. (2021). 10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial). Annals of Surgical Oncology, 28(SUPPL 1), S147-S147.

@article{6a00bf9ab8294ffebf892dd353065404,

title = "10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial)",

abstract = "Background: Neoadjuvant chemoradiotherapy according to the Chemo-Radiotherapy for Oesophageal cancer followed by Surgery Study (CROSS)has become a standard of care for patients with locally advanced resectableesophageal or junctional cancer. However, the long-term benefits andharms remain unclear.We aimed to assess the long-term outcomes of thisregimen.Materials and Methods: From 2004 through 2008, 366 patients wererandomly assigned to either five weekly cycles of intravenous carboplatin(area under the curve of 2 mg/mL/min) and paclitaxel (50 mg/m2 bodysurfacearea) on days 1, 8,15, 22, and 29 with concurrent radiotherapy (41.4Gy in 23 fractions, 5 days per week) followed by surgery, or surgery alone.Follow-up data were collected through 2018. Overall survival was estimatedwith the Kaplan-Meier method and compared with Cox regressionanalyses. The effect beyond 5 years of follow-up was assessed by usinglandmark analyses. Also, cause-specific mortality was estimated with cumulativeincidence functions and compared with Cox regression.Results: The median follow-up was 147 months (IQR 134-157). Patientswho received neoadjuvant chemoradiotherapy had better overall survival(HR 0.70, 95%CI 0.55-0.89), with 10-year overall survival of 38% (95%CI 31-45) in the neoadjuvant chemoradiotherapy plus surgery arm and 25% (95%CI 19-32) in the surgery alone arm. Landmark analyses showed that theoverall survival benefit that was gained in the first 5 years, persistedbeyond 5 years. The risk of death from esophageal cancer was lower forpatients who received neoadjuvant chemoradiotherapy plus surgery (HR0.60, 95% CI 0.46-0.80), while death from other causes was comparablebetween both study arms (HR 1.17, 95%CI 0.68-1.99).Conclusions: The overall survival benefit of patients with locally advancedresectable esophageal or esophagogastric junctional cancer who receivedneoadjuvant chemoradiotherapy plus surgery according to the CROSSregimen persists for at least 10 years, compared with surgery alone.",

author = "{CROSS Study Grp} and Eyck, {Ben M.} and {van Lanschot}, {J. Jan B.} and Hulshof, {Maarten C. C. M.} and {van der Wilk}, {Berend J.} and Joel Shapiro and {van Hagen}, Pieter and Henegouwen, {Mark I. van Berge} and Wijnhoven, {Bas P. L.} and {van Laarhoven}, {Hanneke W. M.} and Nieuwenhuijzen, {Grard A. P.} and Hospers, {Geke A. P.} and Bonenkamp, {Johannes J.} and Cuesta, {Miguel A.} and Blaisse, {Reinoud J. B.} and Busch, {Olivier R.} and Creemers, {Geert-Jan M.} and Punt, {Cornelis J. A.} and Plukker, {John Th. M.} and Verheul, {Henk M. W.} and Bilgen, {Ernst J. Spillenaar} and {van der Sangen}, {Maurice J. C.} and Tom Rozema and {ten Kate}, {Fiebo J. W.} and Beukema, {Jannet C.} and Piet, {Anna H. M.} and {van Rij}, {Caroline M.} and Reinders, {Janny G.} and Tilanus, {Hugo W.} and Steyerberg, {Ewout W.} and {van der Gaast}, Ate",

year = "2021",

month = feb,

language = "English",

volume = "28",

pages = "S147--S147",

journal = "Annals of Surgical Oncology",

issn = "1068-9265",

publisher = "Springer",

number = "SUPPL 1",

}

CROSS Study Grp, Eyck, BM, van Lanschot, JJB, Hulshof, MCCM, van der Wilk, BJ, Shapiro, J, van Hagen, P, Henegouwen, MIVB, Wijnhoven, BPL, van Laarhoven, HWM, Nieuwenhuijzen, GAP, Hospers, GAP, Bonenkamp, JJ, Cuesta, MA, Blaisse, RJB, Busch, OR, Creemers, G-JM, Punt, CJA, Plukker, JTM, Verheul, HMW, Bilgen, EJS, van der Sangen, MJC, Rozema, T, ten Kate, FJW, Beukema, JC, Piet, AHM, van Rij, CM, Reinders, JG, Tilanus, HW, Steyerberg, EW & van der Gaast, A 2021, '10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial)', Annals of Surgical Oncology, vol. 28, no. SUPPL 1, pp. S147-S147.

TY - JOUR

T1 - 10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial)

AU - CROSS Study Grp

AU - Eyck, Ben M.

AU - van Lanschot, J. Jan B.

AU - Hulshof, Maarten C. C. M.

AU - van der Wilk, Berend J.

AU - Shapiro, Joel

AU - van Hagen, Pieter

AU - Henegouwen, Mark I. van Berge

AU - Wijnhoven, Bas P. L.

AU - van Laarhoven, Hanneke W. M.

AU - Nieuwenhuijzen, Grard A. P.

AU - Hospers, Geke A. P.

AU - Bonenkamp, Johannes J.

AU - Cuesta, Miguel A.

AU - Blaisse, Reinoud J. B.

AU - Busch, Olivier R.

AU - Creemers, Geert-Jan M.

AU - Punt, Cornelis J. A.

AU - Plukker, John Th. M.

AU - Verheul, Henk M. W.

AU - Bilgen, Ernst J. Spillenaar

AU - van der Sangen, Maurice J. C.

AU - Rozema, Tom

AU - ten Kate, Fiebo J. W.

AU - Beukema, Jannet C.

AU - Piet, Anna H. M.

AU - van Rij, Caroline M.

AU - Reinders, Janny G.

AU - Tilanus, Hugo W.

AU - Steyerberg, Ewout W.

AU - van der Gaast, Ate

PY - 2021/2

Y1 - 2021/2

N2 - Background: Neoadjuvant chemoradiotherapy according to the Chemo-Radiotherapy for Oesophageal cancer followed by Surgery Study (CROSS)has become a standard of care for patients with locally advanced resectableesophageal or junctional cancer. However, the long-term benefits andharms remain unclear.We aimed to assess the long-term outcomes of thisregimen.Materials and Methods: From 2004 through 2008, 366 patients wererandomly assigned to either five weekly cycles of intravenous carboplatin(area under the curve of 2 mg/mL/min) and paclitaxel (50 mg/m2 bodysurfacearea) on days 1, 8,15, 22, and 29 with concurrent radiotherapy (41.4Gy in 23 fractions, 5 days per week) followed by surgery, or surgery alone.Follow-up data were collected through 2018. Overall survival was estimatedwith the Kaplan-Meier method and compared with Cox regressionanalyses. The effect beyond 5 years of follow-up was assessed by usinglandmark analyses. Also, cause-specific mortality was estimated with cumulativeincidence functions and compared with Cox regression.Results: The median follow-up was 147 months (IQR 134-157). Patientswho received neoadjuvant chemoradiotherapy had better overall survival(HR 0.70, 95%CI 0.55-0.89), with 10-year overall survival of 38% (95%CI 31-45) in the neoadjuvant chemoradiotherapy plus surgery arm and 25% (95%CI 19-32) in the surgery alone arm. Landmark analyses showed that theoverall survival benefit that was gained in the first 5 years, persistedbeyond 5 years. The risk of death from esophageal cancer was lower forpatients who received neoadjuvant chemoradiotherapy plus surgery (HR0.60, 95% CI 0.46-0.80), while death from other causes was comparablebetween both study arms (HR 1.17, 95%CI 0.68-1.99).Conclusions: The overall survival benefit of patients with locally advancedresectable esophageal or esophagogastric junctional cancer who receivedneoadjuvant chemoradiotherapy plus surgery according to the CROSSregimen persists for at least 10 years, compared with surgery alone.

AB - Background: Neoadjuvant chemoradiotherapy according to the Chemo-Radiotherapy for Oesophageal cancer followed by Surgery Study (CROSS)has become a standard of care for patients with locally advanced resectableesophageal or junctional cancer. However, the long-term benefits andharms remain unclear.We aimed to assess the long-term outcomes of thisregimen.Materials and Methods: From 2004 through 2008, 366 patients wererandomly assigned to either five weekly cycles of intravenous carboplatin(area under the curve of 2 mg/mL/min) and paclitaxel (50 mg/m2 bodysurfacearea) on days 1, 8,15, 22, and 29 with concurrent radiotherapy (41.4Gy in 23 fractions, 5 days per week) followed by surgery, or surgery alone.Follow-up data were collected through 2018. Overall survival was estimatedwith the Kaplan-Meier method and compared with Cox regressionanalyses. The effect beyond 5 years of follow-up was assessed by usinglandmark analyses. Also, cause-specific mortality was estimated with cumulativeincidence functions and compared with Cox regression.Results: The median follow-up was 147 months (IQR 134-157). Patientswho received neoadjuvant chemoradiotherapy had better overall survival(HR 0.70, 95%CI 0.55-0.89), with 10-year overall survival of 38% (95%CI 31-45) in the neoadjuvant chemoradiotherapy plus surgery arm and 25% (95%CI 19-32) in the surgery alone arm. Landmark analyses showed that theoverall survival benefit that was gained in the first 5 years, persistedbeyond 5 years. The risk of death from esophageal cancer was lower forpatients who received neoadjuvant chemoradiotherapy plus surgery (HR0.60, 95% CI 0.46-0.80), while death from other causes was comparablebetween both study arms (HR 1.17, 95%CI 0.68-1.99).Conclusions: The overall survival benefit of patients with locally advancedresectable esophageal or esophagogastric junctional cancer who receivedneoadjuvant chemoradiotherapy plus surgery according to the CROSSregimen persists for at least 10 years, compared with surgery alone.

M3 - Meeting Abstract

SN - 1068-9265

VL - 28

SP - S147-S147

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - SUPPL 1

ER -

10-year Outcome of a Randomized Trial Comparing Neoadjuvant Chemoradiotherapy and Surgery with Surgery Alone for Esophageal Cancer (CROSS trial)

Abstract

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