(SANO) Neoadjuvant chemoradiotherapy plus standard surgery versus active surveillance for oesophageal cancer

Project summary

The outlook for patients with esophageal cancer is often not good, even after major surgery. This surgery is very drastic and can reduce the quality of life. Unnecessary operations must therefore be prevented. Previous studies have shown that chemo-radiotherapy prior to the operation causes the tumor to shrink sufficiently in one third of the esophageal cancer patients, so that major surgery may not be necessary.
In this project, the researchers will investigate whether a major operation is still needed in patients in which esophageal cancer has virtually disappeared after chemo-radiotherapy. The researchers will follow an active surveillance strategy: patients will only undergo surgery if, after chemo-radiotherapy, a proven tumor residue, without metastases, is still present.

This study will show whether the surgery after chemo-radiotherapy can be omitted in some of the esophageal cancer patients. If this is the case, this most likely will lead to a comparable long-term survival despite 37% fewer esophageal operations. Preventing unnecessary surgery probably means a better quality of life for the patient and it also may save costs.