Induction therapy for squamous carcinoma of thoracic esophagus

• Published in: The Annals of thoracic surgery Vol. 57; no. 5; pp. 1126 - 1132
• Main Authors: Laterza, Ernesto, Griso, Claudia, Urso, Ugo S., de' Manzoni, Giovanni, Malagò, Massimo, Oliani, Cristina, Cordiano, Claudio
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-1994; Elsevier Science
• Subjects: Adult; Aged; Antineoplastic agents; Biological and medical sciences; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Combined Modality Therapy; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - therapy; Female; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Survival Rate; Human; Chemotherapy; Squamous cell carcinoma; Surgery; Esophageal disease; Adjuvant treatment; Digestive diseases; Malignant tumor; Preoperative; Radiotherapy; Esophagus
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(94)91341-2

From June 1987 to March 1992, 70 patients with squamous cell carcinoma of the esophagus were entered into a treatment protocol that included a preoperative course of radiotherapy (3,000 cGy) and chemotherapy (cisplatin and 5-fluoruracil). The preoperative therapy was well tolerated. Forty-nine of these patients underwent esophageal resection (total or subtotal) and 6 patients died subsequently (12.2%). The morbidity was not dramatically affected by preoperative treatment. Histopathologic studies showed no residual disease in the resected specimen of 11 patients (19.2%), only some residual microscopic clusters of neoplastic cells in 8 patients (14%) and macroscopic cancer in the remaining patients (66.8%). The estimated overall Kaplan-Meier survival at 1,2, and 3 years was 53.6%, 28.6%, and 21.5%, respectively. Our study, like other reports, demonstrates an improved survival in the group of patients who had a complete response after radiotherapy or chemotherapy (
p = 0.002). Moreover, the lack of diagnostic procedures to evaluate the presence of residual tumor after radiotherapy and chemotherapy, suggests that only surgical resection can provide an accurate prognostic information and a complete treatment.