Is esophagectomy following upfront chemoradiotherapy safe and necessary?

Archives of Surgery
J M KaneM C Posner

Abstract

To examine the safety and necessity of esophagectomy following upfront chemoradiotherapy (CRT) in patients with potentially resectable esophageal cancer. Cohort analytic study during a 4-year period. Tertiary referral center. Thirty-seven patients who completed CRT and underwent esophagectomy as compared with 30 patients who underwent esophagectomy alone without pretreatment during the same period. Resection-related events, perioperative morbidity and mortality, response to CRT, site of residual disease following CRT, and survival of partial responders. Patients receiving CRT followed by esophagectomy were similar to patients who underwent esophagectomy alone for operative characteristics, postoperative course, and perioperative morbidity and mortality. Of the 33 patients who achieved an objective response to CRT, 23 had residual tumor in the resection specimen. Of the 18 patients alive with no evidence of disease at a median follow-up of 30 months, 50% had residual tumor following CRT. Upfront CRT did not adversely affect resection-related outcome and may facilitate resection by downstaging disease. A considerable number of patients had prolonged survival after esophageal resection despite having residual tumor present followi...Continue Reading

Citations

Sep 15, 1998·The Journal of Surgical Research·L L ShearsM Posner
Jun 26, 2003·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J D UrschelF W Sellke
Mar 22, 2001·The British Journal of Surgery·J I GehR Glynne-Jones
Apr 12, 2000·Cancer Control : Journal of the Moffitt Cancer Center·S Teng, R Karl

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