M Victorzon1, P Tolonen, M Kohonen, M Salmo. 1. Department of Gastrointestinal Surgery, Vasa Central Hospital, Vasa, Finland. mikael.victorzon@vshp.fi
Abstract
AIMS: To critically assess the outcome of surgery for oesophageal carcinoma, with or without neoadjuvant chemoradiotherapy. METHODS: Since April 1998 until August 2002 resectable oesophageal cancer patients referred to us have received multimodal treatment, consisting of two courses of fluorouracil, cisplatin and hydroxyurea and 2 x 20 Gy of radiotherapy followed by surgery. The outcome of this treatment was compared to the outcome of a historical group of oesophageal cancer patients, treated with surgery alone in the time period 1994 to 1998. The patients represent a consecutive series of 20 resectable oesophageal carcinomas, referred to us since 1994. Four patients (20%) were treated for squamocellular carcinoma, 16 (80%) patients for adenocarcinoma. RESULTS: Treatment related toxicity was low and there was no death attributable to the chemoradiotherapy. Postoperative hospital mortality (< 30 days) and morbidity rates were 10% and 50%, respectively. A complete pathological response (T0) occurred in two of the nine patients in the multimodal group (22%). Overall median survival was 11 months. Median survival among patients in the multimodal group was 14 months, as compared with 7 months in the group treated with surgery alone (P = 0.041). CONCLUSIONS: Despite low volume, outcome of surgery for oesophageal carcinoma was acceptable.
AIMS: To critically assess the outcome of surgery for oesophageal carcinoma, with or without neoadjuvant chemoradiotherapy. METHODS: Since April 1998 until August 2002 resectable oesophageal cancerpatients referred to us have received multimodal treatment, consisting of two courses of fluorouracil, cisplatin and hydroxyurea and 2 x 20 Gy of radiotherapy followed by surgery. The outcome of this treatment was compared to the outcome of a historical group of oesophageal cancerpatients, treated with surgery alone in the time period 1994 to 1998. The patients represent a consecutive series of 20 resectable oesophageal carcinomas, referred to us since 1994. Four patients (20%) were treated for squamocellular carcinoma, 16 (80%) patients for adenocarcinoma. RESULTS: Treatment related toxicity was low and there was no death attributable to the chemoradiotherapy. Postoperative hospital mortality (< 30 days) and morbidity rates were 10% and 50%, respectively. A complete pathological response (T0) occurred in two of the nine patients in the multimodal group (22%). Overall median survival was 11 months. Median survival among patients in the multimodal group was 14 months, as compared with 7 months in the group treated with surgery alone (P = 0.041). CONCLUSIONS: Despite low volume, outcome of surgery for oesophageal carcinoma was acceptable.