SANO 5-year update, #ESMO26 LBA78.

Some surprises.

Study Design:
Surveillance vs surgery after cCR to CRT in locally advanced esophageal cancer (n=309).

5-year OS ~50% vs 54% (NS), HR 1.17 (95% CI 0.77–1.77)

Distant mets 46% vs 29% (P<.01). This met rate is higher and now significant.

Reminder: only 41.4 Gy/23 fx. A pre-op, arguably non-definitive dose, especially with ~75% adenocarcinoma.

Does this apply in the DFLOT + post-CROSS era? Either way, upper GI harder to tackle non-op than hoped.

@OncoAlert @TheGutOncLab @Onco_Nexus