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Should cT2 esophageal cancer get neoadjuvant treatment before surgery?
- Source :
- Journal of Thoracic Disease. 9:2819-2823
- Publication Year :
- 2017
- Publisher :
- AME Publishing Company, 2017.
-
Abstract
- In recent years treatment options for esophageal cancer were expanding as randomized trials have shown a beneficial effect of preoperative chemotherapy and of chemoradiotherapy (1-7). However, it is unclear whether early stage cancers also benefit from preoperative therapy since the number of patients included in such randomized trials is small (8-10). In a more recently published randomized trial, Mariette et al. (11) investigated the benefit of preoperative chemoradiotherapy in stage I and II esophageal carcinomas. A total of 195 patients were randomized between primary surgery and preoperative chemoradiotherapy (cisplatin/5- FU +45 Gy), followed by surgery. Despite of a significant downstaging and a pathologic complete remission (pCR) in 33.3% of cases in the chemoradiotherapy group, no improvement of neither R0 resection rate nor overall survival were observed. Moreover, there was no difference in postoperative complications but there was an increase in hospital mortality in the chemoradiotherapy group (11.1% vs. 3.4%), which may have affected the overall outcome of the trial. Due to these results neoadjuvant treatment for T2 esophageal cancer remains highly controversial.
- Subjects :
- Pulmonary and Respiratory Medicine
Cisplatin
medicine.medical_specialty
Preoperative Therapy
business.industry
Esophageal cancer
medicine.disease
law.invention
Surgery
03 medical and health sciences
Editorial
0302 clinical medicine
Randomized controlled trial
Neoadjuvant treatment
law
030220 oncology & carcinogenesis
Medicine
030211 gastroenterology & hepatology
Stage (cooking)
business
Chemoradiotherapy
Pathologic Complete Remission
medicine.drug
Subjects
Details
- ISSN :
- 20776624 and 20721439
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of Thoracic Disease
- Accession number :
- edsair.doi.dedup.....6e19e28c79d41cdeac231fc854349be6