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ESMO 2023 | SANO trial: neoadjuvant chemoradiotherapy vs. active Surveillance in esophageal cancer

Magnus Nilsson, MD, PhD, FACS, Karolinska University Hospital, Stockholm, Sweden, discusses findings from the Phase III SANO trial (NTR6803 8-11-2017) a noninferiority stepped-wedge cluster randomized trial focusing on patients with esophageal cancer who demonstrated a clinically complete response (CCR) after neoadjuvant chemoradiotherapy (nCRT). The study compared active surveillance (with surgery only if locoregional regrowth occurred) to standard surgery. The primary endpoint, overall survival (OS) from the day of CCR, demonstrated noninferiority for active surveillance after two years (HR 0.88). Patients on active surveillance experienced improved short-term health-related quality of life (HRQOL). Extended follow-up is planned to assess the long-term efficacy of active surveillance in this patient population. The study took place at the European Society for Medical Oncology (ESMO) 2023 Congress in Madrid, Spain.

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