The CROSS road in neoadjuvant therapy for esophageal cancer: long-term results of CROSS trial

Despite improvement in surgical results after esophagectomy, the long-term prognosis of patients with esophageal carcinoma remains suboptimal. With emergence of multimodality treatment strategies in recent decades, various regimens of neoadjuvant therapy have become commonplace. The Dutch Chemoradiotherapy for Oesophageal Cancer followed by Surgery Study (CROSS) trial was first published in 2012 and recently updated with its long-term results. It was a randomized controlled trial that involved 368 patients including both adenocarcinoma and squamous cell carcinoma of the esophagus and gastroesophageal junction. Patients were randomized into either surgery alone group (188 patients) or chemoradiotherapy (weekly administration of carboplatin and paclitaxel with concurrent radiotherapy 41.4 Gy) followed by surgery (171 patients).