Anzeige
Erschienen in:
01.09.2014 | Gastrointestinal Oncology
The Usefulness of Neoadjuvant Chemoradiation Therapy for Locally Advanced Esophageal Cancer with Multiple Lymph-Node Metastases
Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2014
Einloggen, um Zugang zu erhaltenAbstract
Background
The prognosis of patients with esophageal squamous-cell cancer (ESCC) and multiple lymph-node metastases is quite poor. We examined whether neoadjuvant chemoradiation therapy (CRT) has a beneficial effect in such patients.
Methods
A total of 50 consecutive patients with T3–4 tumors and without organ metastases were prospectively enrolled. Of those patients, 20, who had four or more nodal metastases, underwent neoadjuvant CRT (CRT group), and the remaining 30 patients, who had three or fewer nodal metastases, underwent surgery alone (surgery group). CRT consisted of 5-fluorouracil plus cisplatin and 40 Gy of radiation. The groups’ clinical outcomes were compared.
Results
Surgery was performed in 48 patients: all enrolled patients except for 2 who had organ metastasis after CRT. In the CRT group, the number of patients with pathological complete response was observed in 8 patients (44 %), mean nodal metastases number was changed from 8.2 to 2.6 and 9 patients had pN0. The 3-year survival rate was 76 % in the CRT group (4 patients relapsed) and 68 % in the surgery group (8 patients relapsed), which is not a statistically significant difference (P = 0.61).
Conclusions
Neoadjuvant CRT is beneficial for locally advanced ESCC with four or more lymph-node metastases.