Survival of patients with carcinoma of the esophagus treated with combined-modality therapy

Wolfe, Walter G.; Vaughn, Anna; Seigler, Hilliard F.; Hathorn, James W.; Leopold, Kenneth A.; Duhaylongsod, Francis G.

doi:10.1016/s0022-5223(19)34204-7

Cited by 79 publications

(28 citation statements)

References 15 publications

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“…Studies suggest that good histological response of tumors correlates well with longer survival. 11,13,16,17 Grade 3 patients make up a small number in our study, but the results of the present study suggest that if the response to CRT is effective, long-term survival may be acquired from surgery after CRT. Therefore, correct identification of patients who respond to CRT before surgery is crucial.…”

Section: Discussionmentioning

confidence: 63%

Resection surgery with neoadjuvant chemoradiotherapy improves outcomes of patients with T4 esophageal carcinoma

Noguchi

Moriyama

Wada

et al. 2003

Diseases of the Esophagus

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The prognosis of patients with T4 esophageal carcinoma is poor, and thus an effective treatment needs to be established. The present study assessed the effect of chemoradiotherapy (CRT), postoperative morbidity and mortality, and survival time in 41 patients with T4 esophageal carcinoma. Of these, 24 received CRT followed by surgery (group A) and the remaining 17 were treated with CRT alone (group B). Postoperative complications in group A were compared with 251 patients (group C) who underwent surgery without CRT during the same period. Postoperative complications were more frequent in group A than group C (29.2% vs 8.4%, P < 0.05). The overall median survival of group A was statistically longer than that of group B (13.8 months and 3.3 months respectively, P < 0.001). Complete histologic response (grade 3) was documented in 4 group A patients (16.7%). The overall median survival of grade 3 patients was statistically longer than the rest of group A (38.9 months vs 8.8 months, P < 0.05). The data confirm that chemoradiotherapy creates tumor regression in some patients and allows resection surgery in T4 esophageal carcinoma. Moreover, surgery with CRT confers a survival advantage in T4 esophageal carcinoma.

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Section: Discussionmentioning

confidence: 63%

Resection surgery with neoadjuvant chemoradiotherapy improves outcomes of patients with T4 esophageal carcinoma

Noguchi

Moriyama

Wada

et al. 2003

Diseases of the Esophagus

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“…At present, the most promising strategy is preoperative chemoradiotherapy followed by surgery [7]. Recently, many studies have shown that preoperative chemoradiotherapy leads to downstaging of the disease and increases the curative resection rate [8][9][10][11]. Although randomized controlled trials comparing surgery alone with preoperative chemoradiotherapy followed by surgery have not yet yielded definitive conclusions on the usefulness of chemoradiotherapy [12][13][14][15][16], many investigators have reported that responders to chemoradiotherapy show better prognosis than non-responders.…”

Section: Introductionmentioning

confidence: 99%

Correlation between histological effects on the main tumors and nodal status after chemoradiotherapy for squamous cell carcinoma of the esophagus

et al. 2005

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“…Concurrent chemoradiation is the most commonly used treatment modality for patients with locally advanced esophageal cancer in the USA. 1 Chemoradiation is administered as definitive [2][3][4][5][6] or prior to surgery. [7][8][9][10][11] Complete remission rates of 25 -30% have been described with chemoradiation.…”

Section: Introductionmentioning

confidence: 99%

Should preoperative, post-chemoradiotherapy endoscopy be routine for esophageal cancer patients?

Shaukat

Mortazavi

Demmy

et al. 2004

Diseases of the Esophagus

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Chemoradiation therapy is used widely for locoregional esophageal cancer. Patients with persistent disease may benefit from surgery. Preoperative esophagoscopy can identify persistent tumor but its accuracy is uncertain. The primary objective of this study is to assess the extent of agreement between esophagoscopy and surgical pathology in patients treated with neoadjuvant chemoradiation. A retrospective chart review of patients who underwent chemoradiation, preoperative endoscopy and surgery from January 1996 to December 2002 was performed. Cohen's kappa statistic was used to measure the degree of agreement between findings at endoscopic biopsy and surgical pathology. Thirty cases were identified. All patients received chemoradiation followed by surgical resection. There was insufficient agreement between tumor size (kappa 0.25, standard error 0.17, P = 0.07) and appearance (kappa 0.19, standard error 0.18, P = 0.14). Preoperative endoscopy revealed atypia/inflammation in 15 cases and dysplasia in eight. Of these 23 cases, 11 were adenocarcinomas at surgery. Only nine patients had concurrence between surgical pathology and endoscopy. The positive and negative predictive values of esophagoscopy for identifying residual tumor were 100% and 11%, respectively. Our data suggests that after chemoradiation, esophagoscopy is unreliable for excluding residual disease. The roles of other modalities need to be explored.

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Survival of patients with carcinoma of the esophagus treated with combined-modality therapy

Cited by 79 publications

References 15 publications

Resection surgery with neoadjuvant chemoradiotherapy improves outcomes of patients with T4 esophageal carcinoma

Resection surgery with neoadjuvant chemoradiotherapy improves outcomes of patients with T4 esophageal carcinoma

Correlation between histological effects on the main tumors and nodal status after chemoradiotherapy for squamous cell carcinoma of the esophagus

Should preoperative, post-chemoradiotherapy endoscopy be routine for esophageal cancer patients?

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