Revolutionary study: New hope in the fight against esophageal cancer!

Revolutionary study: New hope in the fight against esophageal cancer!

Around 85,700 people worldwide are diagnosed with esophageal adenocarcinoma every year, a type of cancer that primarily develops in the lower part of the esophagus. Professor Dr. Jens Höppner, head of the University Clinic for General and Visceral Surgery at the Lippe Clinic, led the ESOPEC study, the results of which were recently published in the New England Journal of Medicine. This study stands out not only for its comprehensive methodology, but also for the fact that it was conducted by an interdisciplinary team without financial support from pharmaceutical companies. 25 institutions in Germany specializing in cancer were involved.

The main cause of esophageal adenocarcinoma is the rise of stomach acid, which can lead to cell changes. Risk factors include obesity, smoking, alcohol consumption and a high-fat diet. In the last 30 years, the incidence of this form of cancer has increased sevenfold. While the study compared two treatment methods – chemotherapy and radiotherapy (CROSS) versus perioperative chemotherapy (FLOT) – 438 patients were enrolled between 2016 and 2020. The aim was to find out which method offers better survival rates.

Study results in detail

Results from the ESOPEC trial show that patients who received perioperative chemotherapy lived an average of 66 months, which is 29 months longer than those who received only preoperative treatment. These data suggest an approximately 30 percent lower risk of death for the perioperative chemotherapy group. Patient follow-up continued until 2023 to document relapses or deaths.

Additionally, the study examined primary endpoints such as overall survival as well as secondary objectives such as progression-free survival and postoperative morbidity. A poor comparison between neoadjuvant chemoradiation and perioperative chemotherapy lagged behind in the previous literature, making the need for this study even more evident.

Influence on treatment guidelines

The publication of the study results has already had an impact on national and international treatment guidelines, which were immediately adjusted after publication. Höppner also presented the results at the ASCO annual meeting in the USA, where they met with great international interest. The European ESOM guidelines have been updated accordingly to take into account the new findings.

Esophageal cancer, classified under ICD-10 C15, shows poor survival prospects. According to the most recent data available, the 5-year relative survival rate is estimated at 25 percent for men and 24 percent for women. Men become ill three times more often than women and, on average, three years earlier. According to reports, about 3.6 percent of cancer deaths in men are due to this cancer, while only 1.3 percent of women are affected. Obesity and gastroesophageal reflux disease (Barrett esophagus) are relevant risk factors.

In summary, the ESOPEC study provides important new insights for the treatment of esophageal cancer and could further advance clinical practice taking into account the latest scientific findings. However, the urgency for targeted research in this area remains.

For further information about the study and esophageal cancer you can visit the platforms of Bielefeld University Bielefeld University, pubmed and krebsdaten.de be resorted to.