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Esophageal cancer: Outcomes of surgery, neoadjuvant chemotherapy, and three‐dimension conformal radiotherapy
Author(s) -
Fréchette Éric,
Buck David A.,
Kaplan Brian J.,
Chung Theodore D.,
Shaw James E.,
Kachnic Lisa A.,
Neifeld James P.
Publication year - 2004
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20094
Subject(s) - medicine , esophageal cancer , neoadjuvant therapy , radiation therapy , carboplatin , chemotherapy , multimodal therapy , surgery , cancer , oncology , breast cancer , cisplatin
Neoadjuvant chemotherapy and radiation are being utilized with increasing frequency in the multimodal treatment of esophageal cancer, although their effects on morbidity, mortality, and survival remain unclear. The objective of this study was to determine the outcome of multimodal treatment in patients with localized esophageal cancer treated at a single institution. Between 1995 and 2002, 118 patients underwent treatment for localized esophageal cancer, utilizing surgery alone, chemoradiation alone, or surgery following neoadjuvant chemoradiation. There was no statistically significant difference in morbidity, mortality, or length of stay between the patients who received multimodal therapy when compared to surgery alone. A surgical resection after down‐staging was possible in 9 out of 28 patients (32%) with a clinically non‐resectable tumor (T4 or M1a). Forty‐seven percent of the patients who received neoadjuvant therapy had a complete pathologic response with a 3‐year survival of 59% as compared to only 20 months in those patients who did not achieve a complete response ( P = 0.037). Neoadjuvant chemotherapy administered concomitantly with conformal radiotherapy can be performed safely in the treatment of esophageal cancer, without increasing the operative morbidity, mortality, or length of stay. The higher complete response rates to neoadjuvant treatment (as compared to other reports) may be due to the use of three‐dimensional conformal radiation therapy or the novel use of weekly carboplatin and paclitaxel. J. Surg. Oncol. 2004;87:68–74. © 2004 Wiley‐Liss, Inc.