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Post-chemoradiation surgical pathology stage can customize the surveillance strategy in patients with esophageal adenocarcinoma.
[esophageal adenocarcinoma]
Current
algorithms
for
surveillance
of
patients
with
esophageal
adenocarcinoma
(
EAC
)
after
chemoradiation
and
surgery
(
trimodality
therapy
[
TMT
]
)
remain
empiric
.
The
authors
hypothesized
that
the
frequency
,
type
,
and
timing
of
relapses
after
TMT
would
be
highly
associated
with
surgical
pathology
stage
(
SPS
)
,
and
therefore
SPS
could
be
used
to
individualize
the
surveillance
strategy
.
Between
2000
and
2010
,
518
patients
with
EAC
were
identified
who
underwent
TMT
at
The
University
of
Texas
MD
Anderson
Cancer
Center
and
were
frequently
surveyed
.
Frequency
,
type
,
and
timing
of
the
first
relapse
(
locoregional
and
/
or
distant
)
were
tabulated
according
to
SPS
.
Standard
statistical
approaches
were
used
.
The
median
follow-up
time
after
esophageal
surgery
was
55
.
4
months
(
range
,
1
.
0
-
149
.
2
months
)
.
Disease
relapse
occurred
in
215
patients
(
41
.
5
%
)
.
Higher
SPS
was
associated
with
a
higher
rate
of
relapse
(
0
/
I
vs
II
/
III
,
P
≤
.
001
;
0
/
I
vs
II
,
P
=
.
002
;
SPS
0
/
I
vs
III
,
P
≤
.
001
;
and
SPS
II
vs
III
,
P
=
.
005
)
and
with
shorter
time
to
relapse
(
P
<
.
001
)
.
Irrespective
of
the
SPS
,
approximately
95
%
of
all
relapses
occurred
within
36
months
of
surgery
.
The
3
-
and
5
-
year
overall
survival
rates
were
shorter
for
patients
with
a
higher
SPS
than
those
with
a
lower
SPS
(
0
/
I
vs
II
/
III
,
P
≤
.
001
;
0
/
I
vs
II
,
P
≤
.
001
;
0
/
I
vs
III
,
P
≤
.
001
;
and
II
vs
III
,
P
=
.
014
)
.
The
compelling
data
show
an
excellent
association
between
SPS
and
frequency
/
type
/
timing
of
relapses
after
TMT
in
patients
with
EAC
.
Thus
,
the
surveillance
strategy
can
potentially
be
customized
based
on
SPS
.
These
data
can
inform
a
future
evidence-based
surveillance
strategy
that
can
be
efficient
and
cost-effective
.
Diseases
Validation
Diseases presenting
"surgical pathology stage"
symptom
esophageal adenocarcinoma
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