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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenocarcinoma, Adult, Aged, Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Chemoradiotherapy, Adjuvant, Chemotherapy, Adjuvant, Cisplatin, Deglutition Disorders, Disease-Free Survival, Epirubicin, Esophageal Neoplasms, Female, Fluorouracil, Humans, Induction Chemotherapy, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Organoplatinum Compounds, Oxaliplatin, Postoperative Care, Preoperative Care, Preoperative Period, Prognosis, Treatment Outcome.
user
Does persistent Dysphagia After Induction Chemotherapy in Patients with Esophageal Adenocarcinoma predict Poor Post-Operative Outcomes? Context: Preoperative therapy is frequently employed in the management of esophageal adenocarcinoma. However, many patients are found to have advanced pathologic stage and have poor outcomes. A prognostic factor which identifies this patient population before surgery would be desirable, as alternative treatment strategies may be warranted. Between 2/08 and 1/12, 60 evaluable patients with locally advanced esophageal adenocarcinoma enrolled in single-arm phase II trial of induction chemotherapy, surgery, and post-operative adjuvant chemo-radiotherapy (CRT). A clinical stage of T3, N1, or M1a (AJCC 6th) was required for eligibility. Induction chemotherapy with epirubicin 50 mg/m Persistent dysphagia was associated with worse distant metastatic control [HR 3.48 (1.43-8.43), p = 0.006], recurrence free survival [HR 3.04 (1.34-6.92), p = 0.008], and overall survival [HR 3.31 (1.43-7.66), p = 0.005]. Persistent dysphagia was associated with more advanced pathologic T descriptor (pT) (p = 0.048) and N descriptor (pN) (p = 0.002), a greater median number of involved lymph nodes (3 v 1, p = 0.003), and greater residual tumor viability (p = 0.05). No patients with persistent dysphagia had pT0-T2 or pN0 disease.
assistant
Persistent dysphagia after induction chemotherapy is associated with more advanced pathologic stage and inferior outcomes. Final Decision: yes