Clinical practice and outcome of radiotherapy for esophageal cancer between 1999 and 2003: the Japanese Radiation Oncology Study Group (JROSG) Survey

Nishimura, Yasumasa; Koike, Ryuta; Ogawa, Kazuhiko; Sasamoto, Ryuta; Murakami, Yuji; Itoh, Yoshio; Negoro, Yuji; Itasaka, Satoshi; Sakayauchi, Toru; Tamamoto, Tetsuro

doi:10.1007/s10147-011-0254-y

Cited by 21 publications

(17 citation statements)

References 28 publications

(53 reference statements)

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“…In the present study, 28 patients who did not undergo additional OP showed only 3.5% of local relapse without any death caused by post-ESD complications. This result was better than the rates of previous reports (6,7) (Table 7). Moreover, the rate was better than the rate of the Kobe University Hospital study of CRT treatment for clinical stage I esophageal SQC (local relapse rate: 14%, n=21).…”

Section: Discussioncontrasting

confidence: 78%

“…Acute and late cardiopulmonary toxicity due to CRT is a critical issue (34)(35)(36) and is observed in 2-10% of the patients according to previous reports (6,7,(8)(9)(10)(11). To prevent it, not only the improvement of radiation techniques, but also a reduction of the radiation dose to the esophagus, heart and lung are important.…”

Section: Discussionmentioning

confidence: 99%

“…However, 22% of the patients showed local relapses which required salvage treatments. Furthermore, the association of CRT with a high rate of serious late toxicities, especially to the heart and pleura, were reported (7,8). For the patients who have multiple comorbidities, poor performance status, and are elderly, late toxicities after CRT often become a critical fatal issue (9)(10)(11).…”

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confidence: 99%

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Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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Objective The standard treatment for submucosal esophageal cancer is esophagectomy or chemoradiotherapy (CRT). However, these treatment modalities could deteriorate the general condition and quality of life of the patients who are intolerant to invasive therapy. It is therefore important and beneficial to develop less invasive treatment protocols for these patients. Methods The study included 43 patients who were clinically suspected of mucosa or submucosal esophageal cancer but underwent endoscopic submucosal dissection (ESD) as a primary treatment, due to the patients' poor performance statuses and/or preferences for less invasive therapy. According to the pathological findings and patient's general condition, whether the patient underwent additional treatments or remained hospitalized without additional treatments was thereafter decided for each patient. We retrospectively analyzed the outcomes of these patients. Results Fifteen patients underwent additional surgery, 11 patients underwent CRT/radiation therapy (RT) and 17 patients were followed without additional treatments. During the 3-year follow-up period, the relapsefree survival rates in the patients who received or did not receive additional treatments were 88% and 64%, respectively (95% confidence interval, 0.45-0.76, p=0.04). The relapse-free and overall survival rates in the patients with additional treatments were equivalent or superior to those described in previous reports of the standard treatments. Preceding ESD contributed to reduce the local relapse significantly to approximately 3.5% and additional CRT-related toxicities. Conclusion Preceding ESD is very effective for the local control of cancer, and useful for histologically confirming the high-risk factors of relapse, such as ! submucosal layer 2 (SM2) invasion and lymphovascular involvements. ESD with additional therapy may be a promising strategy for optimizing the selection of therapy depending on the patient's general condition.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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“…In prospective studies of definitive CRT for unresectable esophageal cancer, the complete response (CR) rate of T4 tumors ranged from 15-32 %, and 3-year overall survival rates of approximately 20 % have been reported [3][4][5]. A retrospective survey of 9 major Japanese institutions revealed median 3-and 5-year overall survival rates of 21 % (range 10-36 %) and 19 % (range 0-31 %), respectively, for unresectable stage III-IVA tumors by definitive CRT [6].…”

Section: Introductionmentioning

confidence: 97%

Clinical results of definitive-dose (50 Gy/25 fractions) preoperative chemoradiotherapy for unresectable esophageal cancer

et al. 2014

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“…[15][16][17] No tratamento do cancro do esófago, a radioterapia aplicada isoladamente, ou após quimio-sensibilização, como tem sido a nossa preferência, tem demonstrado resultados interessantes, apesar de não ser desprovida de complicações graves e poder necessitar de salvage surgery num número significativo de casos. [18][19][20][21][22][23] A intenção deste trabalho foi apresentar os resultados da estratégia multimodal de tratamento do cancro do esó-fago, tendo sido geralmente decidida a opção da componente operatória do processo com base na localização do tumor.…”

Section: Introductionunclassified

Cancro do Esófago: Estratégia de Abordagem Cirúrgica

et al. 2014

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Acta Med Port 2014 Sep-Oct;27(5):593-600 RESUMOIntrodução: A ressecção transmediastínica e a ressecção transtorácica têm mortalidade hospitalar (1,4% -14%) e sobrevivência (± 25% aos cinco anos) semelhantes. A terapêutica neo-adjuvante é opção em estádios avançados. A intenção deste trabalho é apresentar uma série consecutiva de 52 doentes -opção operatória baseada na localização anatómica: tumores infra-carinais e cervicais submetidos a ressecção transmediastínica e restantes ressecções transtorácicas. Discussão: Não tendo sido demonstrada vantagem oncológica para a ressecção transtorácica ou a ressecção transmediastínica, basear a opção operatória na localização do tumor permitiu-nos com segurança e eficácia, planear e executar as ressecções esofági-cas desta série. Conclusão: As curvas de sobrevida foram sobreponíveis para ressecção transtorácica e ressecção transmediastínica e bastante favoráveis numa população com 52 % de estádios pIII/IV. A quimio-radioterapia contribuiu para aumentar a ressecabilidade. Palavras-chave: Esofagectomia; Laparoscopia; Neoplasias Esofágicas/cirurgia; Toracotomia. ABSTRACT Introduction:Oesophagectomy for cancer is associated to a significant morbidity and mortality. The superiority of transthoracic vs transhiatal is still a matter of controversy. The aim of this paper is to discuss the results of a series of patients submitted to either a transthoracic or a transhiatal according to the anatomic location regarding the carina. Material and Methods: Retrospective analysis of 52 consecutive patients, with oesophageal carcinoma, 7 female and 45 males, median age 64 years. Location: cervical -1; above carina -22; below or at carina level -19; cardia type I -10. 19 adenocarcinoma, 32 squamous cells, 1 lymphoma. Twenty patients (40%) -neo-adjuvant therapy. Thoracoabdominal approach -3, cervico-thoracoabdominal -20, transhiatal -27, exploratory thoracotomy -2. Gastric pull-up 49 (cervical anastomosis -46; thoracic -3); cervical oesofagocoloplasty -1. Results: Pathologic staging: complete remission -8; Ib -3; IIa -9; IIb -4; IIa -11; IIIb -2; IIIc -10; IV -1; non-stageable -3. Major complications: 37%. Resectability: 96% (50/52). Mortality: 4th week -6%; in-hospital -14%. Median survival 18 months . Survival Curves (Kaplan-Meier): 2 years -47%; 5 years -19% (transthoracic vs transhiatal p > 0.05). Discussion: Selection of surgical approach based on the anatomic location of the tumour regarding the carina was safe, the resectability was high and similar when a transthoracic or a transhiatal was planed and carry-on. Conclusions: In this series of oesophageal cancer patients, in advanced pathologic condition (52% p Stages III/IV) the overall survival was similar for transthoracic and transhiatal. Neo-adjuvant treatments definitively contributed to enhance resectability.

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Clinical practice and outcome of radiotherapy for esophageal cancer between 1999 and 2003: the Japanese Radiation Oncology Study Group (JROSG) Survey

Abstract: Although the overall survival rates for stage I esophageal cancer were excellent, a significant disparity in survival rates was noted among the institutions for stage II-IVA tumors treated by CRT.

Cited by 21 publications

References 28 publications

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

Clinical results of definitive-dose (50 Gy/25 fractions) preoperative chemoradiotherapy for unresectable esophageal cancer

Cancro do Esófago: Estratégia de Abordagem Cirúrgica

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