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Table 2 Patient characteristics and survival in GEJ carcinoma trials

From: Radiotherapy for tumors of the stomach and gastroesophageal junction – a review of its role in multimodal therapy

Clinical Trial ACCORD07 CROSS Stahl 2009
Number of patients randomized 224 368 126
Histology Adenocarcinoma: 100% Adenocarcinoma: 75%; SCC: 23%; other: 2% Adenocarcinoma: 100%
Tumor location Distal esophagus: 11%; GEJ: 64%; stomach: 25% Esophagus+: 73%; GEJ: 24%; Unspecified: 3% 100% GEJ Siewert I: 55%, Siewert II/III: 45%
Treatment in CT/CRT arm Cisplatin and FU§ in perioperative combination with surgery Neoadjuvant carboplatin & paclitaxel with concurrent 41.8/1.8Gy, followed by surgery Neoadjuvant PLF#, followed by cisplatin & etoposide with concurrent 30/2Gy, followed by surgery
Treatment in control arm Surgery only Surgery only PLF#, followed by surgery
TNM in CT/CRT arm * T0: 3%; T1-2: 39%; T3-4: 58%; N0: 33%; N+: 67%; M0: 99%; M1: 1% T1-2: 16%; T3-4: 84%; unspecified T: 1%; N0: 33%; N+: 65%; unspecified N: 2% T1-2: 0%; T3: 92%; T4: 8%; N0: 64%; N+: 36%
TNM in control arm ‡ * T1-2: 32%; T3-4: 68%; N0: 20%; N+ 80%; M0: 93%; M1: 7% T1-2: 20%; T3-4: 79%; unspecified T: 2%; N0: 31%; N+: 64%; unspecified N: 5% T1-2: 0%; T3: 92%; T4: 8%; N0: 37%; N+: 63%
OS in CT/CRT arm 5-year: 38% (p=0.02) 5-year: 47%; 3-year: 58%; median: 49.4 months (p=0.003) Median: 33.1months; 3-year: 47.4% (p=0.07)
OS in control arm 5-year: 24% (p=0.02) 5-year: 34%; 3-year: 44%; median: 24 months (p=0.003) Median: 21.1months 3-year: 27.7% (p=0.07)
DFS in CT/CRT arm 5-year: 34% (p=0.003) Median DFS not reached (p<0.001) 3-Y: 41.3% (P not significant, value not reported)
DFS in control arm 5-year: 19% (p=0.003) Median DFS 24.2 months (p<0.001) 3-Y: 24.9% (P not significant, value not reported)
Postoperative mortality in CT/CRT arm 4.6% (p=0.76) 4% (P not significant, value not reported) 10.2% (p=0.26)
Postoperative mortality in control arm 4.5% (p=0.76) 4% (P not significant, value not reported) 3.8% (p=0.26)
R0 resection rate in CT/CRT arm 84% (p=0.04) R0: 92% (p<0.001) 72% (P not significant, value not reported)
R0 resection rate in control arm 74% (p=0.04) R0: 69% (p<0.001) 69% (P not significant, value not reported)
Complete response in CT/CRT arm Unspecified 29% (23% in adenocarcinoma patients, 49% in SCC patients) 15.6% (p=0.03)
Complete response in control arm - - 2% (p=0.03)
Tumor free LN at time of surgery in CT/CRT arm 33% (p=0.054) 69% (p<0.001) 64% (p=0.01)
Tumor free LN at time of surgery in control arm 20% (p=0.054) 25% (p<0.001) 37% (p=0.01)
  1. + Locations of esophageal carcinomas were further specified as follows: proximal third: 2%; middle third: 13%; distal third 58%.
  2. ‡ Control arm in ACCORD07 and CROSS was surgery only; Stahl 2009 had no surgery only arm, we considered CT without radiotherapy as control arm in this table.
  3. § FU: fluorouracil.
  4. # PLF: cisplatin, fluorouracil, and leucovorin.
  5. * TNM in ACCORD07 is pathologically (pTNM) staged; TNM in CROSS is clinically (cTNM) by means of endoscopic ultrasonography, computed tomography (CT), or 18F-fluorooxyglucose positron-emission tomography; TNM in Stahl 2009 is clinically for T-staging (uT), but pathological for N-staging.
  6. † All mentioned p-values refer to comparison of the specified factor between CT/CRT arm, and control arm.
  7. Patient characteristics and outcome of patients with GEJ- and esophageal carcinoma; in ACCORD07 and CROSS trial, surgery only arm was regarded as control arm; in Stahl 2009, neoadjuvant PLF without irradiation followed by surgery was considered control arm while neoadjuvant CRT was considered CT/CRT arm.