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dc.contributor.authorLiu, DHW
dc.contributor.authorŠefčovičová, N
dc.contributor.authorEmmerson, J
dc.contributor.authorSpaans, LN
dc.contributor.authorSaito, Y
dc.contributor.authorHutchins, G
dc.contributor.authorNankivell, MG
dc.contributor.authorLangley, RE
dc.contributor.authorAllum, W
dc.contributor.authorCunningham, D
dc.contributor.authorLanger, R
dc.contributor.authorGrabsch, HI
dc.coverage.spatialEngland
dc.date.accessioned2022-08-12T14:54:54Z
dc.date.available2022-08-12T14:54:54Z
dc.date.issued2022-07-01
dc.identifierS0959-8049(22)00236-2
dc.identifier.citationEuropean Journal of Cancer, 2022, 170 pp. 140 - 148en_US
dc.identifier.issn0959-8049
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/5263
dc.identifier.eissn1879-0852
dc.identifier.eissn1879-0852
dc.identifier.doi10.1016/j.ejca.2022.04.026
dc.identifier.doi10.1016/j.ejca.2022.04.026
dc.description.abstractBACKGROUND: Adenocarcinoma with more than 50% extracellular mucin is a relatively rare histological subtype of gastrointestinal adenocarcinomas. The clinical impact of extracellular mucin in oesophageal adenocarcinoma (OeAC) has not been investigated in detail. We hypothesised that patients with mucinous OeAC (OeACmucin) do not benefit from neoadjuvant chemotherapy. METHODS: OeAC patients either treated by surgery alone in the OE02 trial (S-patients) or by neoadjuvant chemotherapy followed by surgery (CS-patients) in OE02 or OE05 trials were included. Cancers from 1055 resection specimens (OE02 [test cohort]: 187 CS, 185 S; OE05 [validation cohort]: 683 CS) were classified as either mucinous (more than 50% of the tumour area consists of extracellular mucin, OeACmucin) or non-mucinous adenocarcinoma (OeACnon-mucin). The relationship between histological phenotype, clinicopathological characteristics, survival and treatment was analysed. RESULTS: Overall, 7.3% and 9.6% OeAC were classified as OeACmucin in OE02 and OE05, respectively. In OE02, the frequency of OeACmucin was similar in S and CS-patients. Patients with OeACmucin treated with surgery alone had a poorer overall survival compared with OeACnon-mucin patients (hazard ratio: 2.222, 95% confidence interval: 1.08-4.56, P = 0.025). Patients with OeACmucin treated with neoadjuvant chemotherapy and surgery had similar survival as OeACnon-mucin patients in test and validation cohort. CONCLUSIONS: This is the first study to suggest in a post-hoc analysis of material from two independent phase III clinical trials that the poor survival of patients with mucinous OeAC can be improved by neoadjuvant chemotherapy. Future studies are warranted to identify potential underlying biological, biochemical or pharmacokinetic interactions between extracellular mucin and chemotherapy.
dc.formatPrint-Electronic
dc.format.extent140 - 148
dc.languageeng
dc.language.isoengen_US
dc.publisherELSEVIER SCI LTDen_US
dc.relation.ispartofEuropean Journal of Cancer
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectMucinous adenocarcinoma
dc.subjectNeoadjuvant chemotherapy
dc.subjectOesophageal adenocarcinoma
dc.subjectSurvival
dc.subjectAdenocarcinoma
dc.subjectAdenocarcinoma, Mucinous
dc.subjectEsophageal Neoplasms
dc.subjectHumans
dc.subjectMucins
dc.subjectNeoadjuvant Therapy
dc.subjectPrognosis
dc.subjectUnited Kingdom
dc.titleNeoadjuvant chemotherapy improves survival in patients with oesophageal mucinous adenocarcinoma: Post-hoc analysis of the UK MRC OE02 and OE05 trials.en_US
dc.typeJournal Article
dcterms.dateAccepted2022-04-16
dc.date.updated2022-08-12T14:54:25Z
rioxxterms.versionVoRen_US
rioxxterms.versionofrecord10.1016/j.ejca.2022.04.026en_US
rioxxterms.licenseref.startdate2022-07-01
rioxxterms.typeJournal Article/Reviewen_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/35635935
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.publication-statusPublished
pubs.volume170
icr.researchteamMedicine (RMH)en_US
dc.contributor.icrauthorCunningham, David
icr.provenanceDeposited by Mr Arek Surman on 2022-08-12. Deposit type is initial. No. of files: 1. Files: 1-s2.0-S0959804922002362-main.pdf


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