• Ben M Eyck, Xing Gao, Yang Yang, Berend J van der Wilk, Ian Wong, WijnhovenBas P LBPLDepartment of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, the Netherlands., Jun Liu, Sjoerd M Lagarde, Lam Ka-On, HulshofMaarten C C MMCCMDepartment of Radiation Oncology, Cancer Centre Amsterdam, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands., Zhigang Li, Simon Law, Yin Kai Chao, van LanschotJ Jan BJJBDepartment of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, the Netherlands., and Dutch Upper Gastrointestinal Cancer Audit (DUCA).
• Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, the Netherlands.
• Br J Surg. 2022 Nov 22; 109 (12): 131213181312-1318.

BackgroundPatients with different ethnic and genetic backgrounds may respond differently to anticancer therapies. This study aimed to assess whether patients with oesophageal squamous cell carcinoma (OSCC) treated with neoadjuvant chemoradiotherapy (nCRT) in East Asia had an inferior pathological response compared with patients treated in Northwest Europe.MethodsPatients with OSCC who underwent nCRT according to the CROSS regimen (carboplatin and paclitaxel with concurrent 41.4 Gy radiotherapy) followed by oesophagectomy between June 2012 and April 2020 were identified from East Asian and Dutch databases. The primary outcome was pCR, defined as ypT0 N0. Groups were compared using propensity score matching, adjusting for sex, Charlson Co-morbidity Index score, tumour location, cT and cN categories, interval between nCRT and surgery, and number of resected lymph nodes.ResultsOf 725 patients identified, 133 remained in each group after matching. A pCR was achieved in 37 patients (27.8 per cent) in the Asian database and 58 (43.6 per cent) in the Dutch database (P = 0.010). The rate of ypT1-4 was higher in Asian than Dutch data (66.2 and 49.6 per cent; P = 0.004). The ypN1-3 rate was 44.4 per cent in the Asian and 33.1 per cent in the Dutch data set. Clear margins were achieved in 92.5 per cent of Asian and 95.5 per cent of Dutch patients.ConclusionRegional differences in responses to CROSS nCRT for oesophageal cancer were apparent, the origin of which will need evaluation.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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