AIM: To clarify the clinical significance of definitive chemoradiotherapy (CRT) and CRT followed by esophagectomy for cT4 esophageal cancer. PATIENTS AND METHODS: The treatment results for cT4 esophageal cancer were examined in 81 patients who received definitive CRT [radiation 50-70 Gy, cisplatin and 5-fluorouracil; group I] and 19 patients who underwent esophagectomy after preoperative CRT [40Gy, Group II]. RESULTS: Among the 81 patients in group I, toxicities (grade 3 or 4) were observed in 32 patients, while partial response and complete response were recognized in 8 and 47 patients, respectively. Of the 19 group II patients, an R0 resection was performed in 16 patients, and the mortality rate was 5%. The 5-year survival rates were 19% and 42% in groups I and II, respectively. CONCLUSION: Long-term survival can be expected after multimodal therapy, even for patients with cT4 esophageal cancer. Esophagectomy is therefore a valid treatment option when down-staging can be achieved.
AIM: To clarify the clinical significance of definitive chemoradiotherapy (CRT) and CRT followed by esophagectomy for cT4 esophageal cancer. PATIENTS AND METHODS: The treatment results for cT4 esophageal cancer were examined in 81 patients who received definitive CRT [radiation 50-70 Gy, cisplatin and 5-fluorouracil; group I] and 19 patients who underwent esophagectomy after preoperative CRT [40Gy, Group II]. RESULTS: Among the 81 patients in group I, toxicities (grade 3 or 4) were observed in 32 patients, while partial response and complete response were recognized in 8 and 47 patients, respectively. Of the 19 group II patients, an R0 resection was performed in 16 patients, and the mortality rate was 5%. The 5-year survival rates were 19% and 42% in groups I and II, respectively. CONCLUSION: Long-term survival can be expected after multimodal therapy, even for patients with cT4 esophageal cancer. Esophagectomy is therefore a valid treatment option when down-staging can be achieved.
Authors: William H Allum; Luigi Bonavina; Stephen D Cassivi; Miguel A Cuesta; Zhao Ming Dong; Valter Nilton Felix; Edgar Figueredo; Piers A C Gatenby; Leonie Haverkamp; Maksat A Ibraev; Mark J Krasna; René Lambert; Rupert Langer; Michael P N Lewis; Katie S Nason; Kevin Parry; Shaun R Preston; Jelle P Ruurda; Lara W Schaheen; Roger P Tatum; Igor N Turkin; Sylvia van der Horst; Donald L van der Peet; Peter C van der Sluis; Richard van Hillegersberg; Justin C R Wormald; Peter C Wu; Barbara M Zonderhuis Journal: Ann N Y Acad Sci Date: 2014-09 Impact factor: 5.691