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For the third of patients whose tumour vanishes after chemoradiation, watching closely and operating only if it comes back gave the same survival as immediate surgery.
Stepped-wedge cluster-randomised non-inferiority trial (Lancet Oncology 2025). Two-year OS non-inferior (HR 1.14, 95% CI 0.74-1.78); about a third of surveillance patients avoided oesophagectomy at 2 years, with better short-term quality of life. Regrowth was usually resectable. Establishes organ preservation as an option for cCR, with caveats about surveillance intensity.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
309 analysed.
Numbers not yet public.
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival at 2 years (non-inferiority)primary | Active surveillance | 156 | - | 1.14 (0.74 to 1.78) | 0.55 | link |
| Standard surgery | 118 | - |
Shares Oesophagectomy, CROSS, Oesophageal cancer.
Shares CROSS chemoradiation → surgery → adjuvant nivolumab if residual disease, CROSS, Oesophageal cancer.
Shares Stepped-wedge design, Cluster-randomised trial, Non-inferiority margin and equivalence trials, Non-inferiority trial.
Shares Non-inferiority margin and equivalence trials, Non-inferiority trial, IMRT / IGRT (modern external beam).
Shares Oesophagectomy, Oesophageal cancer.
Shares Non-inferiority margin and equivalence trials, Non-inferiority trial.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Surgery and radiotherapy cure most, get least.
Shares CROSS, Oesophageal cancer.