DOI: 10.1093/dote/doad052.257 ISSN:


Edno Tales Bianchi, Ricardo Galleti, Phellipe Fabbrini Santos Lucas, Tales Barione Reginaldo, Francisco Tustumi, Jorge Souza, Guilherme Namur, Beatriz Azevedo, Jaime Kruger
  • Gastroenterology
  • General Medicine



Today there are 2 main neoadjuvant schemes for the treatment of esophageal tumors: CROSS and FLOT. There are still no data in the literature to categorically state which one is associated with greater complications and mortality and whether there is an impact on the quality of the lymphadenectomy.

We demonstrate our comparative data from each group undergoing curative treatment of esophageal tumor, along with associated complications and number of dissected lymph nodes at a single institution during the Covid-19 pandemic.


A retrospective analysis of 56 patients who underwent curative treatment of esophageal tumor by minimally invasive esophagectomy was carried out. The squamous cell carcinoma group (SCCG) were composed by 28 subjects and of these 23 underwent CROSS, denominated CROSS group (CG). 27 were in the adenocarcinoma of the esophagogastric junction group (AdG) and of these, 23 underwent FLOT, denominated FLOT group (FG).

Complications, in-hospital and 90-day mortality were analyzed, as well as the quality of lymphadenectomy and response to neoadjuvant treatment and compared between groups.


Toxicity complication during preoperative treatment was 3 (10%) in the CG and 8 (28%) in the FG (p < 0.05).

Post-operatory complications was seen 11 in the SCCG (3 pulmonary, 5 fistulas—1 death) and 10 in the AdG (2 pulmonary, 4 fistulas—2 deaths). When analyzing the groups submitted to neoadjuvant therapy (23 FLOT x 23 CROSS), the same number of 8 (34%) were identified with no difference in Clavien-Dindo scale severity.(p > 0,05).

The mean of lymphonodes dissected were similar between 2 groups (27,01 ± 8). Complete response was 13% in FG and 21% in CG with 3 patients (13%) with ypt0n +.


The group submitted to CROSS had a greater tolerance during the preoperative treatment. There was no difference in the number of complications related to the neoadjuvant scheme, as well as the quality of the lymphadenectomy, suggesting that the treatment can be individualized for each patient.

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