A 65-year-old man has a cT3N1M0 squamous cell carcinoma of the mid-thoracic oesophagus. CROSS trial–based neoadjuvant chemoradiotherapy (carboplatin + paclitaxel + concurrent 41.4 Gy RT) is planned. What was the pathological complete response rate and survival benefit demonstrated in the CROSS trial?

• A 5% pathological CR; 3-month OS benefit
• B 15% pathological CR; no significant OS benefit
• C 49% pathological CR in adenocarcinoma; squamous had no benefit
• D 29% pathological CR; median OS improved from 24 to 49 months ✓

Explanation

The CROSS trial (van Hagen et al., NEJM 2012) demonstrated: pathological complete response (pCR) rate of 29% overall (49% in squamous, 23% in adenocarcinoma). Neoadjuvant chemoradiotherapy improved median OS from 24 months to 49 months compared to surgery alone. This established concurrent carboplatin/paclitaxel + RT followed by surgery as the standard treatment for resectable oesophageal and gastroesophageal junction cancers.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.