Neoadjuvant therapy of squamous cell carcinoma of the esophagus: role of resection and benefit in partial responders

Abstract

Twenty-eight patients were treated between 1981 and 1987 with a combination of radiation therapy and two courses of 5-fluorouracil and cisplatin followed by esophageal resection. Sixteen patients (57%) underwent resection. Operative mortality was 6% (1 of 16), and the 15 operative survivors have been followed for more than 23 months. Complete pathological response was achieved in 8 of the 15 patients, and 10 patients (66%) are alive with no evidence of disease; 4 patients (27%) have survived with no evidence of disease for more than 5 years. Four partial responders are alive, and 3 are alive with no evidence of disease for more than 5 years. An aggressive approach with a low mortality has demonstrated survival benefit to complete responders and, contrary to findings of previous reports, has established a role for surgical resection and survival benefit in patients with partial response, with 3 of 7 (47%) patients surviving more than 5 years.