PURPOSES: The purpose of this study was to evaluate the hypothesis that the survival of patients undergoing R0 resection after triplet chemotherapy for resectable esophageal cancer with unfavorable prognostic factors (Category 3) would be similar to that of patients undergoing esophagectomy for esophageal cancer without such factors (Category 1). METHODS: Patients with Category 3 tumors were assigned to receive triplet chemotherapy consisting of 5-fluorouracil, doxorubicin and nedaplatin (FAN) followed by radical esophagectomy. The outcomes of the bimodality treatment for Category 3 patients (n = 25) were compared with those of Category 1 patients (n = 41) in a prospective cohort study. RESULTS: Grade 3 or higher toxicity developed during chemotherapy in 32 % of the Category 3 patients, with no treatment-related deaths. No significant difference was detected in the surgery-related mortality and morbidity rates between the two groups. The recurrence-free survival was significantly worse in Category 3 than in Category 1 patients (p = 0.002), although the overall survival was not significantly different (p = 0.085) between the two groups in cases of R0 resection (5-year survival rates: 34.4 vs. 66.5 %). CONCLUSIONS: Although FAN chemotherapy followed by radical esophagectomy can be safely performed, this treatment modality may not have sufficient power to cure Category 3 disease.
PURPOSES: The purpose of this study was to evaluate the hypothesis that the survival of patients undergoing R0 resection after triplet chemotherapy for resectable esophageal cancer with unfavorable prognostic factors (Category 3) would be similar to that of patients undergoing esophagectomy for esophageal cancer without such factors (Category 1). METHODS:Patients with Category 3 tumors were assigned to receive triplet chemotherapy consisting of 5-fluorouracil, doxorubicin and nedaplatin (FAN) followed by radical esophagectomy. The outcomes of the bimodality treatment for Category 3 patients (n = 25) were compared with those of Category 1 patients (n = 41) in a prospective cohort study. RESULTS: Grade 3 or higher toxicity developed during chemotherapy in 32 % of the Category 3 patients, with no treatment-related deaths. No significant difference was detected in the surgery-related mortality and morbidity rates between the two groups. The recurrence-free survival was significantly worse in Category 3 than in Category 1 patients (p = 0.002), although the overall survival was not significantly different (p = 0.085) between the two groups in cases of R0 resection (5-year survival rates: 34.4 vs. 66.5 %). CONCLUSIONS: Although FAN chemotherapy followed by radical esophagectomy can be safely performed, this treatment modality may not have sufficient power to cure Category 3 disease.
Authors: T Nishimaki; O Tanaka; N Ando; H Ide; H Watanabe; M Shinoda; W Takiyama; H Yamana; K Ishida; K Isono; M Endo; T Ikeuchi; T Mitomi; H Koizumi; M Imamura; T Iizuka Journal: Ann Thorac Surg Date: 1999-12 Impact factor: 4.330
Authors: Katrin M Sjoquist; Bryan H Burmeister; B Mark Smithers; John R Zalcberg; R John Simes; Andrew Barbour; Val Gebski Journal: Lancet Oncol Date: 2011-06-16 Impact factor: 41.316
Authors: Christian G Peyre; Jeffrey A Hagen; Steven R DeMeester; Jan J B Van Lanschot; Arnulf Hölscher; Simon Law; Alberto Ruol; Ermanno Ancona; S Michael Griffin; Nasser K Altorki; Thomas W Rice; John Wong; Toni Lerut; Tom R DeMeester Journal: Ann Surg Date: 2008-12 Impact factor: 12.969
Authors: Nabil P Rizk; Hemant Ishwaran; Thomas W Rice; Long-Qi Chen; Paul H Schipper; Kenneth A Kesler; Simon Law; Toni E M R Lerut; Carolyn E Reed; Jarmo A Salo; Walter J Scott; Wayne L Hofstetter; Thomas J Watson; Mark S Allen; Valerie W Rusch; Eugene H Blackstone Journal: Ann Surg Date: 2010-01 Impact factor: 12.969