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New Chemotherapy Option Helps Prevent Esophageal Cancer Coming Back

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Recurrence Patterns of Esophageal Adenocarcinoma in the Phase III ESOPEC Trial Comparing Perioperative Chemotherapy - Preoperative Chemoradiotherapy.DOI 10.1200JCO-25-00948

Esophageal adenocarcinoma is a type of cancer that affects the food pipe. Surgery is often needed, but the cancer can still return after treatment. A new study shows that the kind of treatment given around surgery can make a big difference in keeping the cancer from coming back.

The study compared two treatment plans:

⦿ FLOT chemotherapy given before and after surgery

⦿ CROSS chemoradiotherapy (a mix of chemo and radiation) given before surgery

The results showed that patients who received FLOT had better outcomes. After three years, 55 out of 100 FLOT patients were still free of cancer, compared to 39 out of 100 in the CROSS group.

The biggest difference was in how the cancer came back. The FLOT group had fewer cases of the cancer spreading to other parts of the body (called distant recurrence). Both groups had similar rates of the cancer coming back near the original tumor (called locoregional recurrence).

This means FLOT chemotherapy may help stop the cancer from spreading throughout the body better than CROSS. Both treatments were about the same when it came to controlling the cancer near the esophagus.

Choosing the right treatment plan depends on many things. But this study gives new hope for people facing surgery for esophageal cancer. FLOT may offer a better chance at long-term recovery.

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Dr Harsh Shah - GI & HPB Oncosurgeon in Ahmeadbad
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