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| 1 | Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus显示文摘AIM:To assess tumour regression grade(TRG)and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy.METHODS:Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005and 2011 at a single institution were reviewed.Triplet neoadjuvant chemotherapy consisting of platinum,fluoropyrimidine and anthracycline was considered for operable patients(World Health Organization performance status≤2)with clinical stage T2-4 N0-1.Response to neoadjuvant chemotherapy(NAC)was assessed using TRG,as described by Mandard et al.In addition lymph node downstaging was also assessed.Lymph node downstaging was defined by cN1 at diagnosis:assessed radiologically(computed tomography,positron emission tomography,endoscopic ultrasonography),then pathologically recorded as N0 after surgery;ypN0 if NAC given prior to surgery,or pN0if surgery alone.Patients were followed up for 5 years post surgery.Recurrence was defined radiologically,with or without pathological confirmation.An association was examined between t TRG and lymph node downstaging with disease free survival(DFS)and a comprehensive range of clinicopathological characteristics.RESULTS:Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years(median follow up:2.552,95%CI:2.022-3.081).There was a 1.8%(n=4)inpatient mortality rate.One hundred and thirty-six(62.4%)patients received NAC,with 74.3%(n=101)of patients demonstrating some signs of pathological tumour regression(TRG 1-4)and 5.9%(n=8)having a complete pathological response.Forty four point one percent(n=60)had downstaging of their nodal disease(cN1 to ypN0),compared to only 15.9%(n=13)that underwent surgery alone(pre-operatively overstaged:cN1 to pN0),(P<0.0001).Response to NAC was associated with significantly increased DFS(mean DFS;TRG 1-2:5.1years,95%CI:4.6-5.6 vs TRG 3-5:2.8 years,95%CI:2.2-3.3,P<0.0001).Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC(median DFS;TRG 3-5 and nodal down-staging:5.533 years,95%CI:3.558-7.531 vs TRG 3-5 and no nodal down-staging:1.114 years,95%CI:0.961-1.267,P<0.0001).CONCLUSION:Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS. | Fergus Noble Luke Nolan Adrian C Bateman James P Byrne Jamie J Kelly Ian S Bailey Donna M Sharland Charlotte N Rees Timothy J Iveson Tim J Underwood Andrew R Bateman | 2013 | World Journal of Gastroenterology2013，19，48： | 4 |
| 2 | Congenital cytomegalovirus: new progress in an old disease 显示文摘 | Luck S Sharland M | 2008 | Paediatr & Child Health2008，19，4： | 1 |
| 3 | Using fetal nuchal translucency toscreen for major congenital cardiac defects at 10-14 weeks gesta-tion:population based cohort study显示文摘 | Hyett J Perdu M Sharland G | 1999 | BMJ1999，318，7176： | 1 |
| 4 | The Value of Nonselling Activities at International Trade Shows显示文摘 | Sharland A and Balogh P | 1996 | Industrial Marketing Management1996，25，： | 1 |
| 5 | Fetal tachycardias:management and outcome of 127 consecutive cases 显示文摘 | SIMPSON JM SHARLAND GK | 1998 | Heart1998，79，6： | 1 |
| 6 | Screening for congenital heart disease prenatally: result of a 2 and 1/2 year study in the sound east thames region显示文摘 | Sharland GK Allan LD | 1992 | Br J Obstet Gynecol1992，99，： | 1 |
| 7 | Neonatal sepsis:An international perspective显示文摘 | Verqnano S Sharland M Kazembe P | 2005 | Arch Dis Child Fetal Neonatal Ed2005，90，3： | 1 |
| 8 | Fetal tachycardias: management and outcome of 127 consecutive cases 显示文摘 | Simpson J Sharland G | 1998 | Heart1998，7，9： | 1 |
| 9 | Sources of Noise in Axial Flow Fans显示文摘 | Sharland IJ | 1964 | Journal of Sound and Vibration1964，1，： | 1 |
| 10 | World experience of percutaneous ultrazound-gnided baloon valvuloplazty in human fetuses with severe aortic valve obstruction显示文摘 | Kohl T Sharland G Alan LD | 2000 | Am J Cardiol2000，85，10： | 1 |
| 11 | Normal fetal cardiac measurements derived by cross-sectional echoeardiography 显示文摘 | Sharland GK Allan LD | 1992 | Ultrasound Obstet Gyneeol1992，2，： | 1 |
| 12 | Arabian plate sequence stratigraphy显示文摘 | Sharland P R Davies R B Simmons M D | | 0，，1： | 1 |
| 13 | Resurgence of Paediatric tuberculosis in London显示文摘 | Atkinson P Taylor H Sharland M | 2002 | Arch Dis Child2002，86，： | 1 |
| 14 | Advances in the prevention and treatment of pediatric HIV infection in the United Kingdom显示文摘 | Sharland M Gibb DM Tudor-Williams G | 2003 | Sex Transm Infect2003，79，1： | 1 |
| 15 | World-experience of percutaneous ultrasound-guided balloon valvuloplasty in human fetuses with severe aortic valve obstruction显示文摘 | Kohl T Sharland G Allan LD | 2000 | Am J Cardiol2000，86，： | 1 |
| 16 | Using fetal nuchal translucency to screen for major congenital cardiac defects at 10-14 weeks of gestation:population based cohort study显示文摘 | Hyett J Perdu M Sharland G | 1999 | BMJ1999，318，： | 1 |
| 17 | Cytomegalovirus treatment options in immunocompromised patients显示文摘 | Khare MD Sharland M | 2001 | Expert Opin Pharmacother2001，2，8： | 1 |
| 18 | Influenza显示文摘 | Khare MD Sharland M | 2000 | Exp Opin Pharmacother2000，1，3： | 1 |
| 19 | Screening for congenital heart disease prenatally: result of a 2 and 1/2 year study in the Sound East Thames Region显示文摘 | Sharland GK Allan LD | 1992 | Br J Obstet Gynecol1992，99，3： | 1 |
| 20 | Improving the quality of antibiotic prescribing in the NHS by developing a new Anti- microbial Stewardship Programme: Start Smart-Then Focus显示文摘 | Ashiru-Oredope D Sharland M Charani E | 2012 | Jour- nal of Antimicrobial Chemotherapy2012，67，1： | 1 |
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