Premium
Myelotoxicity of preoperative chemoradiotherapy is a significant determinant of poor prognosis in patients with T4 esophageal cancer
Author(s) -
Miyoshi Norikatsu,
Yano Masahiko,
Takachi Ko,
Kishi Kentaro,
Noura Shingo,
Eguchi Hidetoshi,
Yamada Terumasa,
Miyashiro Isao,
Ohue Masayuki,
Ohigashi Hiroaki,
Sasaki Yo,
Ishikawa Osamu,
Doki Yuichiro,
Imaoka Shingi
Publication year - 2009
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.21235
Subject(s) - medicine , esophageal cancer , leukopenia , chemoradiotherapy , univariate analysis , fluorouracil , esophagectomy , multivariate analysis , radiation therapy , oncology , cisplatin , cancer , chemotherapy , surgery , gastroenterology
Purpose Currently, preoperative chemoradiotherapy followed by surgery is the only promising strategy for patients with T4 esophageal cancer. This study retrospectively analyzed the prognostic factors in patients with curatively resected cancer after chemoradiotherapy. Patients and Methods Between September 1989 and December 2003, 42 patients with T4 esophageal cancer received preoperative chemoradiotherapy (CRT) followed by curative surgery. Chemotherapy consisted of 5‐fluorouracil/cisplatin (FP) or 5‐fluorouracil/adriamycin/cisplatin (FAP). A total dose of 40 Gy of radiation was delivered concurrently. Surgery was scheduled 4 weeks after the completion of CRT. The treatment response was categorized using general criteria. Toxicities of the CRT were assessed according to National Cancer Institute of Common Toxicity Criteria (NCI‐CTC). Univariate and multivariate analyses were performed to identify significant prognostic clinicopathological factors. Results The overall survival rate was 38.4% at 5 years. The toxic grade for leukopenia (grade 0–2/3–4) and pathological effect (grade 3/1–2) were significantly different by univariate analysis ( P = 0.03 and 0.05, respectively). Multivariate analysis identified the toxic grade for leukopenia as the only significant and independent determinant of prognosis ( P = 0.05). Conclusion In patients with T4 esophageal cancer who receive CRT followed by curatively resection, myelogenic chemotoxicity is a significant prognostic factor. J. Surg. Oncol. 2009;99:302–306. © 2009 Wiley‐Liss, Inc.