Neoadjuvant Chemoradiotherapy and Surgery Compared With Surgery Alone in Squamous Cell Carcinoma of the Esophagus

Andreollo, Nelson Adami; Tercioti, Valdir; Lopes, Luiz Roberto; Coelho-Neto, João de Souza

doi:10.1590/s0004-28032013000200016

Cited by 7 publications

(7 citation statements)

References 25 publications

(26 reference statements)

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“…Several recent publications assess the role of neoadjuvant therapy in squamous cell carcinoma 2 , 17 , 20 , 36 , 39 , 44 , 47 , regarding the disease-free interval and survival. The PET-CT has been suggested as a method for this assessment, still with inconclusive results 2 , 17 , 20 , 36 , 39 , 44 , 47 . However, doubts on the benefits for global survival of patients still persist 14 , 35 , 45 .…”

Section: Discussionmentioning

confidence: 99%

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Pathologic Complete Response (Ypt0 Ypn0) After Chemotherapy and Radiotherapy Neoadjuvant Followed by Esophagectomy in the Squamous Cell Carcinoma of the Esophagus

Andreollo

Beraldo

Alves

et al. 2018

ABCD, arq. bras. cir. dig.

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Background:Esophageal squamous cell carcinoma is an aggressive neoplasia that requires a multidisciplinary treatment in which survival and prognosis are still not satisfactory. The complete pathologic response to neoadjuvant chemotherapy and radiotherapy is considered a good prognosis factor, and esophagectomy is indicated. Aim:Survival analysis of cases with pathologic complete response (ypT0 ypN0) to neoadjuvant chemotherapy and/or radiotherapy, submmitted to esophagectomy. Methods:Between 1983-2014, 222 esophagectomies were performed, and 177 were conducted to neoadjuvant treatment. In 34 patients the pathologic response was considered complete. Medical records of the patients were retrospectively reviewed regarding type of chemotherapy applied, amount of radiotherapy, interval between the neoadjuvant therapy and the surgery, body mass index; postoperative complications; hospital admission time and survival. Results:The average age was 55.8 years. Twenty-five patients were subjected to chemotherapy and radiotherapy, and nine to neoadjuvant radiotherapy. The total radiation dose ranged from 4400 until 5400 cGy. The chemotherapy was performed with 5FU, cisplatin, and carbotaxol, concomitantly with the radiotherapy. The esophagectomy was transmediastinal, followed by the cervical esophagogastroplasty performed on a average of 49.4 days after the neoadjuvant therapy. The hospital admission time was an average of 14.8 days. During the follow-up period, 52% of the patients submitted to radiotherapy and chemotherapy were disease-free, with 23.6% of them presenting more than five years survival. Conclusions:The neoadjuvant treatment followed by esophagectomy in patients with pathologic complete response is beneficial for the survival of patients with esophageal squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

“…The responders might show complete or incomplete response. The tumoral complete pathologic response to the neoadjuvant therapy is determined by the absence of tumoral cells in the post-esophagectomy specimen, which is a good prognostic factor in the treatment of esophageal cancer 2 , 8 , 38 , 44 .…”

Section: Introductionmentioning

confidence: 99%

Pathologic Complete Response (Ypt0 Ypn0) After Chemotherapy and Radiotherapy Neoadjuvant Followed by Esophagectomy in the Squamous Cell Carcinoma of the Esophagus

Andreollo

Beraldo

Alves

et al. 2018

ABCD, arq. bras. cir. dig.

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“…According to Andreollo et al (2013), in a study with 123 patients that had esophageal cancer and underwent esophagectomy, those who underwent neoadjuvant chemotherapy or radiotherapy had higher survival than those who only underwent surgical treatment. In this study, 37.7% of patients with gastrointestinal cancer had some kind of pre-operative treatment.…”

Section: Discussionmentioning

confidence: 99%

Disturbances in sleep patterns of patients undergoing gastrointestinal oncological surgery

Almeida¹,

Gomes²,

Barbosa³

et al. 2017

Biosci. J.

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“…In the past, radiotherapy was used as the only form of treatment for squamous cell carcinoma, demonstrating in some studies, results similar to those of surgery. Recently, chemotherapy and associated radiotherapy have shown better survival results, while radiotherapy as the definitive modality has been reserved for patients who cannot receive chemotherapy 1,2,3,9,10,13,14,22,23 .…”

Section: Introductionmentioning

confidence: 99%

“…The inclusion of systemic chemotherapy in the treatment regimens with multimodality, to control distant micrometastatic disease and improve the effects of local radiation through its radiosensitizing effect, made this practice routine, with the main objective of achieving cytoreduction and decreased staging (downstage) 16,22 . Another advantage of neoadjuvant is the fact that cytoreduction and the consequent tumor reduction, the patient eats better, gains weight and acquires a more appropriate nutritional status for a possible surgical procedure, in addition to improving the quality of life due to the lower rate of dysphagia 1,3,24,26 .…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant Chemoradiotherapy Followed by Transhital Esophagectomy in Locally Advanced Esophageal Squamous Cell Carcinoma: Impact of Pathological Complete Response

Alves¹,

Tercioti²,

Neto³

et al. 2021

ABCD, arq. bras. cir. dig.

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Background Multimodal therapy with neoadjuvant chemoradiotherapy, followed by esophagectomy has offered better survival results, compared to isolated esophagectomy, in advanced esophageal cancer. In addition, patients who have a complete pathological response to neoadjuvant treatment presented greater overall survival and longer disease-free survival compared to those with incomplete response. Aim: To compare the results of overall survival and disease-free survival among patients with complete and incomplete response, submitted to neoadjuvant chemoradiotherapy, with two therapeutic regimens, followed by transhiatal esophagectomy. Methods: Retrospective study, approved by the Research Ethics Committee, analyzing the medical records of 56 patients with squamous cell carcinoma of the esophagus, divided into two groups, submitted to radiotherapy (5040 cGY) and chemotherapy (5-Fluorouracil + Cisplatin versus Paclitaxel + Carboplatin) neoadjuvants and subsequently to surgical treatment, in the period from 2005 to 2012, patients. Results The groups did not differ significantly in terms of gender, race, age, postoperative complications, disease-free survival and overall survival. The 5-year survival rate of patients with incomplete and complete response was 18.92% and 42.10%, respectively (p> 0.05). However, patients who received Paclitaxel + Carboplatin, had better complete pathological responses to neoadjuvant, compared to 5-Fluorouracil + Cisplatin (47.37% versus 21.62% - p = 0.0473, p <0.05). Conclusions There was no statistical difference in overall survival and disease-free survival for patients who had a complete pathological response to neoadjuvant. Patients submitted to the therapeutic regimen with Paclitaxel and Carboplastin, showed a significant difference with better complete pathological response and disease progression. New parameters are indicated to clarify the real value in survival, from the complete pathological response to neoadjuvant, in esophageal cancer.

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Neoadjuvant Chemoradiotherapy and Surgery Compared With Surgery Alone in Squamous Cell Carcinoma of the Esophagus

Abstract: Radiotherapy and chemotherapy neoadjuvants in patients with squamous cell carcinoma of the esophagus offers benefits and increases survival.

Cited by 7 publications

References 25 publications

Pathologic Complete Response (Ypt0 Ypn0) After Chemotherapy and Radiotherapy Neoadjuvant Followed by Esophagectomy in the Squamous Cell Carcinoma of the Esophagus

Pathologic Complete Response (Ypt0 Ypn0) After Chemotherapy and Radiotherapy Neoadjuvant Followed by Esophagectomy in the Squamous Cell Carcinoma of the Esophagus

Disturbances in sleep patterns of patients undergoing gastrointestinal oncological surgery

Neoadjuvant Chemoradiotherapy Followed by Transhital Esophagectomy in Locally Advanced Esophageal Squamous Cell Carcinoma: Impact of Pathological Complete Response

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