BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) is now considered the standard of care by many centers in the treatment of both squamous cell carcinoma (SCC) and adenocarcinoma of the esophagus. This study evaluates the effectiveness of a neoadjuvant CRT protocol, as regards pathological complete response (pCR) rate and long-term survival. METHODS: From 2003 to 2011, at Upper G.I. Surgery Division of Verona University, 155 consecutive patients with locally advanced esophageal cancers (90 SCC, 65 adenocarcinoma) were treated with a single protocol of neoadjuvant CRT (docetaxel, cisplatin, and 5-fluorouracil with 50.4 Gy of concurrent radiotherapy). Response to CRT was evaluated through percentage of pathological complete response (pCR or ypT0N0), overall (OS) and disease-related survival (DRS), and pattern of relapse. RESULTS: One hundred thirty-one patients (84.5 %) underwent surgery. Radical resection (R0) was achieved in 123 patients (79.3 %), and pCR in 65 (41.9 %). Postoperative mortality was 0.7 % (one case). Five-year OS and DRS were respectively 43 and 49 % in the entire cohort, 52 and 59 % in R0 cases, and 72 and 81 % in pCR cases. Survival did not significantly differ between SCC and adenocarcinoma, except for pCR cases. Forty-nine patients suffered from relapse, which was mainly systemic in adenocarcinoma. Only three out of 26 pCR patients with previous adenocarcinoma developed relapse, always systemic. CONCLUSIONS: This study suggests that patients treated with the present protocol achieve good survival and high pCR rate. Further research is necessary to evaluate whether surgery on demand is feasible in selected patients, such as pCR patients with adenocarcinoma.
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) is now considered the standard of care by many centers in the treatment of both squamous cell carcinoma (SCC) and adenocarcinoma of the esophagus. This study evaluates the effectiveness of a neoadjuvant CRT protocol, as regards pathological complete response (pCR) rate and long-term survival. METHODS: From 2003 to 2011, at Upper G.I. Surgery Division of Verona University, 155 consecutive patients with locally advanced esophageal cancers (90 SCC, 65 adenocarcinoma) were treated with a single protocol of neoadjuvant CRT (docetaxel, cisplatin, and 5-fluorouracil with 50.4 Gy of concurrent radiotherapy). Response to CRT was evaluated through percentage of pathological complete response (pCR or ypT0N0), overall (OS) and disease-related survival (DRS), and pattern of relapse. RESULTS: One hundred thirty-one patients (84.5 %) underwent surgery. Radical resection (R0) was achieved in 123 patients (79.3 %), and pCR in 65 (41.9 %). Postoperative mortality was 0.7 % (one case). Five-year OS and DRS were respectively 43 and 49 % in the entire cohort, 52 and 59 % in R0 cases, and 72 and 81 % in pCR cases. Survival did not significantly differ between SCC and adenocarcinoma, except for pCR cases. Forty-nine patients suffered from relapse, which was mainly systemic in adenocarcinoma. Only three out of 26 pCR patients with previous adenocarcinoma developed relapse, always systemic. CONCLUSIONS: This study suggests that patients treated with the present protocol achieve good survival and high pCR rate. Further research is necessary to evaluate whether surgery on demand is feasible in selected patients, such as pCR patients with adenocarcinoma.
Authors: Giuseppe Verlato; Daniele Marrelli; Simone Accordini; Maria Bencivenga; Alberto Di Leo; Alberto Marchet; Roberto Petrioli; Giacomo Zoppini; Michele Muggeo; Franco Roviello; Giovanni de Manzoni Journal: World J Gastroenterol Date: 2015-06-07 Impact factor: 5.742
Authors: C A De Pasqual; J Weindelmayer; S Laiti; R La Mendola; M Bencivenga; L Alberti; S Giacopuzzi; G de Manzoni Journal: Updates Surg Date: 2019-08-13
Authors: Simone Giacopuzzi; Maria Bencivenga; Jacopo Weindelmayer; Giuseppe Verlato; Giovanni de Manzoni Journal: Gastric Cancer Date: 2016-12-30 Impact factor: 7.370
Authors: Giovanni De Manzoni; Daniele Marrelli; Gian Luca Baiocchi; Paolo Morgagni; Luca Saragoni; Maurizio Degiuli; Annibale Donini; Uberto Fumagalli; Maria Antonietta Mazzei; Fabio Pacelli; Anna Tomezzoli; Mattia Berselli; Filippo Catalano; Alberto Di Leo; Massimo Framarini; Simone Giacopuzzi; Luigina Graziosi; Alberto Marchet; Mario Marini; Carlo Milandri; Gianni Mura; Elena Orsenigo; Vittorio Quagliuolo; Stefano Rausei; Riccardo Ricci; Fausto Rosa; Giandomenico Roviello; Andrea Sansonetti; Giovanni Sgroi; Guido Alberto Massimo Tiberio; Giuseppe Verlato; Carla Vindigni; Riccardo Rosati; Franco Roviello Journal: Gastric Cancer Date: 2016-06-02 Impact factor: 7.370
Authors: G Piro; S Giacopuzzi; M Bencivenga; C Carbone; G Verlato; M Frizziero; M Zanotto; M M Mina; V Merz; R Santoro; A Zanoni; G De Manzoni; G Tortora; D Melisi Journal: Br J Cancer Date: 2015-08-20 Impact factor: 9.075