PURPOSE: (18)F-fluorodeoxyglucose positron emission tomography-positive lymph nodes (PET-N positive) in patients with resectable thoracic esophageal squamous cell carcinoma (TESCC) are associated with a high rate of postoperative distant recurrence. The purpose of this study was to evaluate the systemic control and survival benefit of neoadjuvant chemotherapy (NAC, cisplatin + doxorubicin + 5-fluorouracil) in these patients. METHODS: Of 77 patients with resectable TESCC who were PET-N positive, we evaluated 51 treated with NAC + surgery in this study and 26 who had undergone surgery alone (SA) in a previous study. Historical comparisons of the groups were made, and the response to treatment was evaluated in the NAC group. RESULTS: The NAC group had a higher rate of pN0-1 and a lower rate of postoperative recurrence (p < 0.0001 and p < 0.024, respectively) than the SA group; however, their relapse-free survival (RFS) rates were not significantly different. The NAC group had a significantly higher RFS in cT1/T2 cases, but showed similar survival in cT3 cases. On the other hand, post-treatment PET-N-negative patients had a higher RFS (p = 0.008) and a lower rate of distant recurrence (p = 0.021), even with cT3 disease. A multivariate analysis identified the post-treatment PET-N evaluation to be the only significant predictor of the RFS in cT3 cases. CONCLUSIONS: NAC significantly suppressed postoperative recurrence in TESCC PET-N-positive patients, but the survival benefit was unclear. However, post-treatment PET-N-negative patients were likely responders to NAC.
PURPOSE: (18)F-fluorodeoxyglucose positron emission tomography-positive lymph nodes (PET-N positive) in patients with resectable thoracic esophageal squamous cell carcinoma (TESCC) are associated with a high rate of postoperative distant recurrence. The purpose of this study was to evaluate the systemic control and survival benefit of neoadjuvant chemotherapy (NAC, cisplatin + doxorubicin + 5-fluorouracil) in these patients. METHODS: Of 77 patients with resectable TESCC who were PET-N positive, we evaluated 51 treated with NAC + surgery in this study and 26 who had undergone surgery alone (SA) in a previous study. Historical comparisons of the groups were made, and the response to treatment was evaluated in the NAC group. RESULTS: The NAC group had a higher rate of pN0-1 and a lower rate of postoperative recurrence (p < 0.0001 and p < 0.024, respectively) than the SA group; however, their relapse-free survival (RFS) rates were not significantly different. The NAC group had a significantly higher RFS in cT1/T2 cases, but showed similar survival in cT3 cases. On the other hand, post-treatment PET-N-negative patients had a higher RFS (p = 0.008) and a lower rate of distant recurrence (p = 0.021), even with cT3 disease. A multivariate analysis identified the post-treatment PET-N evaluation to be the only significant predictor of the RFS in cT3 cases. CONCLUSIONS:NAC significantly suppressed postoperative recurrence in TESCC PET-N-positive patients, but the survival benefit was unclear. However, post-treatment PET-N-negative patients were likely responders to NAC.
Authors: H L van Westreenen; M Westerterp; P M M Bossuyt; J Pruim; G W Sloof; J J B van Lanschot; H Groen; J Th M Plukker Journal: J Clin Oncol Date: 2004-09-15 Impact factor: 44.544
Authors: H Shiozaki; M Yano; T Tsujinaka; M Inoue; S Tamura; Y Doki; T Yasuda; Y Fujiwara; M Monden Journal: Dis Esophagus Date: 2001 Impact factor: 3.429
Authors: Arnaud D Roth; Nicola Fazio; Roger Stupp; Stephen Falk; Jürg Bernhard; Piercarlo Saletti; Dieter Köberle; Markus M Borner; Kaspar Rufibach; Rudolf Maibach; Martin Wernli; Martin Leslie; Robert Glynne-Jones; Lukas Widmer; Matthew Seymour; Filippo de Braud Journal: J Clin Oncol Date: 2007-08-01 Impact factor: 44.544
Authors: David P Kelsen; Katryn A Winter; Leonard L Gunderson; Joanne Mortimer; Norman C Estes; Daniel G Haller; Jaffer A Ajani; Walter Kocha; Bruce D Minsky; Jack A Roth; Christopher G Willett Journal: J Clin Oncol Date: 2007-08-20 Impact factor: 44.544
Authors: Jurjen J Boonstra; Tjebbe C Kok; Bas Pl Wijnhoven; Mark van Heijl; Mark I van Berge Henegouwen; Fiebo Jw Ten Kate; Peter D Siersema; Winand Nm Dinjens; Jan Jb van Lanschot; Hugo W Tilanus; Ate van der Gaast Journal: BMC Cancer Date: 2011-05-19 Impact factor: 4.430