Preoperative chemoradiation in an era of suboptimal clinical staging
Menée à partir des données 1998-2006 de la base de l'"American College of Surgeons" portant sur 1 309 patients atteints d'un adénocarcinome de l'œsophage (durée médiane de suivi : 73,3 mois), cette étude évalue le bénéfice, en termes de survie globale à 3 ans, d'une chimioradiothérapie néoadjuvante en fonction de la présence de métastases ganglionnaires
Gabriel et al have concluded that there are patients who, by current treatment guidelines, would likely receive preoperative chemoradiation who may not require it. It may be appropriate to state (although this is beyond their conclusions) that the additional unnecessary therapy may be harmful, as the FFCD 9901 trial concluded.2 Studies like these that identify subgroups of patients less likely to benefit from multimodality therapy are useful in avoiding overtreatment of patients.
JAMA Surgery , commentaire, 2015