Chemotherapy Followed by Surgery Compared with Surgery Alone for Localized Esophageal Cancer

• Published in: The New England journal of medicine Vol. 339; no. 27; pp. 1979 - 1984
• Main Authors: Kelsen, David P, Ginsberg, Robert, Pajak, Thomas F, Sheahan, Daniel G, Gunderson, Leonard, Mortimer, Joanne, Estes, Norman, Haller, Daniel G, Ajani, Jaffer, Kocha, Walter, Minsky, Bruce D, Roth, Jack A
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 31-12-1998
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - surgery; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cancer therapies; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - surgery; Chemotherapy; Cisplatin - administration & dosage; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - mortality; Esophageal Neoplasms - surgery; Esophagus; Family medical history; Female; Fluorouracil - administration & dosage; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Middle Aged; Neoadjuvant Therapy; Oncology; Surgery; Survival Analysis; Treatment Failure; Tumors; Human; Prognosis; Esophageal disease; Malignant tumor; Esophagus; Chemotherapy; Randomization; Surgery; Digestive diseases; Adult; Combined treatment; Therapeutic protocol; Public health; Comparative study; Localized
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199812313392704

Esophageal carcinoma is an aggressive disease with a poor prognosis. For patients with stage 1, 2, or 3 carcinomas, surgery alone remains one standard of care. Another approach, treatment with radiation plus concurrent chemotherapy, has been shown to be superior to radiation alone.
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Chemotherapy plus radiation but without surgery has not yet been compared in a prospective trial with surgery alone.
Because of the high rates of distant and locoregional failure, there is intense interest in combining regional therapy (such as surgery or radiation) with systemic therapy. In previous studies, chemotherapy had at least moderate effectiveness in treating metastatic . . .