BACKGROUND: The time elapsed between completion of neoadjuvant therapy and esophagectomy may influence response rate and possibly allow for avoidance of surgical intervention in selected cases ("wait and see" approach). However, a very long postradiation interval has been associated with worsened surgical outcomes in @entity418 . Therefore we analyzed outcomes of @entity1 with @entity420 treated with neoadjuvant chemoradiation and esophagectomy based on the time elapsed between completion of neoadjuvant chemoradiation and resection. METHODS: @entity1 with @entity189 diagnosed between 2003 and 2011 and treated by neoadjuvant chemoradiation followed by esophagectomy within 26 weeks were identified in the National Cancer Data Base (NCDB). Primary outcome measures were 30-  and 90-day postsurgical mortality and overall survival. RESULTS: In all, 4,284 @entity1 aged 60.3    9.4 years were analyzed (mean    standard deviation). The interval after radiation therapy until esophagectomy was 7.8      3.4  weeks (median, 7.1 weeks). The postradiation interval was 8 weeks or more in 35% of @entity1 . Thirty-day mortality was 2.9% (n  = 127), and 90-day mortality was 7.8% (n  = 336). A postradiation interval of 9 weeks or more was associated with increased perioperative mortality odds both at the 30-day (adjusted odds ratio [OR], 2.160; 95% confidence interval, 1.099-4.242; p  = 0.025) and 90-day follow-up (adjusted OR, 1.912; 95% confidence interval, 1.290-2.835; p < 0.001). Similarly, a postradiation interval of 9 weeks or more was associated with an increased mortality risk (adjusted hazard ratio [HR], 1.194; 95% confidence interval, 1.032-1.380; p  = 0.017). CONCLUSIONS: Perioperative mortality and overall survival are significantly associated with the time interval between neoadjuvant chemoradiation and esophagectomy. A "wait and see" approach after neoadjuvant therapy for @entity420 may not be safe. Further studies based on more detailed data are needed.

Esophagectomy Timing After Neoadjuvant Therapy for Distal XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity189 :: ('MESH:D002277', 'Disease') :: ['invasive distal esophageal carcinoma'] @entity420 :: ('MESH:D000230', 'Disease') :: ['invasive distal esophageal adenocarcinoma', 'esophageal adenocarcinoma'] @entity418 :: ('MESH:D004938', 'Disease') :: ['esophageal carcinoma']
@entity420 :: (MESH:D000230,Disease) :: ['Esophageal Adenocarcinoma']
