Surgery after induction chemoradiotherapy for oesophageal cancer

Eur J Surg Oncol. 2003 Mar;29(2):158-65. doi: 10.1053/ejso.2002.1335.

Abstract

Aim: We discuss the role of surgery after induction chemoradiotherapy, when a complete response is apparent.

Methods: We enrolled 247 consecutive patients who underwent chemoradiotherapy and oesophagectomy for cancer. Patients were classified in two groups as to whether they had chemoradiotherapy (n = 60) or not (n = 187) before surgery.

Results: The 5-year survival rate of patients with complete response was 54% and was significantly higher than that of the other group (P = 0.018). Of the 60 patients responding, 34 (56.7%) were found to have a complete pathological tumour response (pT0). The overall sensitivity and specificity of the post-chemoradiotherapy restaging were 60.7% and 86.4%.

Conclusions: Complete response after induction chemoradiotherapy is not a reliable tool in the management of oesophageal cancer. We need to improve postchemoradiotherapy restaging to be sure that chemoradiotherapy will provide the same long-term survival rates as surgery.

MeSH terms

  • Adult
  • Aged
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophageal Neoplasms / therapy
  • Esophagectomy
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Rate