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. 1993 Oct;218(4):571-6; discussion 576-8.
doi: 10.1097/00000658-199310000-00017.

Improved survival with neoadjuvant therapy and resection for adenocarcinoma of the esophagus

J R Stewart  1 , S J Hoff, D H Johnson, M J Murray, D R Butler, C C Elkins, K W Sharp, W H Merrill, J L Sawyers
Affiliations

Improved survival with neoadjuvant therapy and resection for adenocarcinoma of the esophagus

J R Stewart et al. Ann Surg. 1993 Oct.

Abstract

Objective: This study sought to determine the impact of preoperative chemotherapy and radiation therapy (neoadjuvant therapy) followed by resection in patients with adenocarcinoma of the esophagus.

Summary background data: Long-term survival in patients with carcinoma of the esophagus has been poor. An increase in the incidence of adenocarcinoma of the esophagus has been reported recently.

Methods: Fifty-eight patients with biopsy-proven adenocarcinoma of the esophagus treated at this institution from January 1951 through February 1993 were studied. Since 1989, 24 patients were entered prospectively into a multimodality treatment protocol consisting of preoperative cisplatin, 5-fluorouracil (5-FU), and leucovorin with or without etoposide, and concomitant mediastinal radiation (30 Gy). Patients were re-evaluated and offered resection.

Results: There were no deaths related to neoadjuvant therapy and toxicity was minimal. Before multimodality therapy was used, the operative mortality rate was 19% (3 of 16 patients). With multimodality therapy, there have been no operative deaths (0 of 23 patients). The median survival time in patients treated before multimodality therapy was 8 months and has yet to be reached for those treated with the neoadjuvant regimen (> 26 months, p < 0.0001). The actuarial survival rate at 24 months was 15% before multimodality therapy and 76% with multimodality therapy. No difference in survival was noted in neoadjuvant protocols with or without etoposide (p = 0.827).

Conclusions: Multimodality therapy with preoperative chemotherapy and radiation therapy followed by resection appears to offer a survival advantage to patients with adenocarcinoma of the esophagus.

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References

    1. J Thorac Cardiovasc Surg. 1975 Nov;70(5):826-35 - PubMed
    1. Br J Cancer. 1952 Jun;6(2):127-30 - PubMed
    1. Hum Pathol. 1986 May;17(5):482-7 - PubMed
    1. J Clin Oncol. 1986 May;4(5):685-96 - PubMed
    1. Ann Surg. 1987 May;205(5):557-62 - PubMed

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