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Table of Contents
LETTER TO EDITOR
Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 165-166

Is CROSS the right approach for locally advanced esophageal cancer in India?


Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India

Date of Submission24-Jan-2022
Date of Decision22-Feb-2022
Date of Acceptance22-Feb-2022
Date of Web Publication31-Mar-2022

Correspondence Address:
H N Arun
Dr M H, Marigowda Road, Hombegowda Nagar, Bengaluru - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_47_22

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How to cite this article:
Arun H N. Is CROSS the right approach for locally advanced esophageal cancer in India?. Cancer Res Stat Treat 2022;5:165-6

How to cite this URL:
Arun H N. Is CROSS the right approach for locally advanced esophageal cancer in India?. Cancer Res Stat Treat [serial online] 2022 [cited 2022 May 21];5:165-6. Available from: https://www.crstonline.com/text.asp?2022/5/1/165/342402



I read with great interest the innovative article in your journal titled, “Neoadjuvant chemoradiotherapy followed by surgery for operable carcinoma esophagus: Ground reality in a tertiary care center of rural India - A retrospective audit,” and the accompanying editorial.[1],[2] I would like to make a few comments from the surgical oncologist's point of view. Induction chemoradiation followed by surgery is associated with the increased morbidity of pulmonary and anastomotic complications compared to upfront surgery. This morbidity can be reduced if a video-assisted thoracoscopic surgical (VATS) procedure is utilized. The perioperative mortality will be low in high-volume centers. The study by Dora et al. reported a good pathological complete remission rate of 60% and >92% R0 resection rate in the patients who received induction chemoradiotherapy. Compared to the data from the CROSS trial,[3] these are very good outcomes, probably attributable to a higher proportion of squamous carcinoma in the Indian population. This shows us the way to achieve better survival outcomes in our patients. Organ preservation with chemoradiotherapy in operable esophageal cancer would be a dream come true for Indian patients, and this is probably not far away. I request the authors' comments on this.

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Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Neoadjuvant chemoradiotherapy followed by surgery for operable carcinoma esophagus: Ground reality in a tertiary care center of rural India-A retrospective audit. Cancer Res Stat Treat 2021;4:647-55.  Back to cited text no. 1
    
2.
Rajappa SJ. At crossroads with CROSS: Implementing the CROSS protocol in a resource-limited setting. Cancer Res Stat Treat 2021;4:734-6.  Back to cited text no. 2
  [Full text]  
3.
van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 2012;366:2074-84.  Back to cited text no. 3
    




 

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