SANO
For the third of patients whose tumour vanishes after chemoradiation, watching closely and operating only if it comes back gave the same survival as immediate surgery.
Stepped-wedge cluster-randomised non-inferiority trial (Lancet Oncology 2025). Two-year OS non-inferior (HR 1.14, 95% CI 0.74-1.78); about a third of surveillance patients avoided oesophagectomy at 2 years, with better short-term quality of life. Regrowth was usually resectable. Establishes organ preservation as an option for cCR, with caveats about surveillance intensity.
- The treated group had about 14 percent higher chance of the event at any given time (hazard ratio 1.14).
- The absolute difference, how many more people out of 100 were helped, is not reported here.
- The likely range for the hazard ratio crosses 1, so the difference could be due to chance.
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: Oesophageal cancer with clinical complete response after CROSS chemoradiation: active surveillance (surgery only on regrowth) vs standard surgery. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
274 participants enrolled.
Numbers not yet public.
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival at 2 years (non-inferiority)primary | Active surveillance | 156 | — | 1.14 (0.74–1.78) | 0.55 | link |
| Standard surgery | 118 | — |