Preoperative Chemotherapy in the Management of Esophageal Carcinoma: Preliminary Report

Abstract

Carcinoma of the esophagus is the most common malignancy of the digestive system seen in our institution. Since mid-1982, a multidrug regimen including fluorouracil, doxorubicin, cisplatin, and etoposide was used for the therapy of this malignancy. Twenty-four patients with squamous cell carcinoma of the esophagus received two cycles of chemotherapy followed by surgery. The resectability rate was 84%. The surgical mortality was 8%. Chemotherapy induced four complete remissions (no residual malignancy in the esophagectomy specimen) and 13 partial remissions. It was well tolerated. The median follow-up from time of surgical resection is 8+ months (range, 1 to 32+ months). To date, five of 18 patients who had tumor resection have developed recurrence of the malignancy. This multidrug chemotherapy regimen is effective against squamous cell carcinoma of the esophagus and has increased the resectability of the tumor when given preoperatively. Further follow-up is needed to determine the effect of the treatment on survival.