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Titolo:
Neoadjuvant therapy for esophageal cancer: Standard of care or elusive myth?
Autore:
Boyle, MJ; Franceschi, D; Robinson, DS; Livingstone, AS;
Indirizzi:
Univ Miami Hosp & Clin, Jackson Mem Hosp, Dept Surg,Div Surg Oncol, Sylvester Comprehens Canc Ctr, Miami, FL USA Univ Miami Hosp & Clin Miami FL USA r Comprehens Canc Ctr, Miami, FL USA
Titolo Testata:
AMERICAN SURGEON
fascicolo: 10, volume: 67, anno: 2001,
pagine: 956 - 965
SICI:
0003-1348(200110)67:10<956:NTFECS>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
SQUAMOUS-CELL CARCINOMA; PHASE-II TRIAL; RADIATION-THERAPY; THORACIC ESOPHAGUS; PREOPERATIVE CHEMORADIATION; TRANSHIATAL ESOPHAGECTOMY; CONCURRENT CHEMOTHERAPY; MULTIMODALITY THERAPY; SCANDINAVIAN TRIAL; 5-FLUOROURACIL ECF;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Boyle, MJ Louisiana State Univ, Hlth Sci Ctr, Dept Surg, 1542 Tulane Ave, New Orleans, LA 70112 USA Louisiana State Univ 1542 Tulane Ave New Orleans LA USA 70112 SA
Citazione:
M.J. Boyle et al., "Neoadjuvant therapy for esophageal cancer: Standard of care or elusive myth?", AM SURG, 67(10), 2001, pp. 956-965

Abstract

Although surgical resection as the sole treatment modality for esophageal carcinoma has historically been associated with poor survival rates, improvements have recently been reported using varied neoadjuvant chemo-radiationprotocols. This study evaluates the outcome of patients undergoing surgeryfor esophageal carcinoma at the University of Miami/Jackson Memorial Hospital between July 1991 and June 1996. Seventy-two patients underwent esophageal resection; 51 males and 21 females with a median age of 62.5 years (range = 42-82). Histology was equally distributed between adenocarcinoma (36 patients; 50%) and squamous cell carcinoma (36 patients; 50%). Pathological stage distribution consisted of 6 stage 0 (8%), 10 stage I (14%), 23 stage II (32%), 31 stage III (43%), and 2 stage IV (3%) lesions. Patients were divided into three groups according to the type of preoperative treatment; Group 1 (n = 44); surgery alone; Group 2 (n = 18); neoadjuvant 5-fluorouracilbased chemotherapy, and Group 3 (n = 9); neoadjuvant 5-fluorouracil based chemotherapy in conjunction with external beam radiation (XRT). One patientreceived preoperative XRT alone. All survivors were followed for a minimumof 1 year and statistical analysis was performed using Kaplan-Meier curves, log-rank, and chi-square tests. In the 28 patients receiving any form of neoadjuvant therapy only one patient had a pathological complete response (CR) (3.5%). The overall 5 year and median survival rates were 18 per cent and 20.5 months (range = 0-73), respectively. Individual treatment group survival rates at 5 years were 28% for Group 1; 21% for Group 2; and 0% for Group 3, showing no survival difference between Groups 1 and 2; Group 3 faredsignificantly worse than the other two, probably as a result of the high operative mortality in this group. These results indicate that surgical resection continues to be an important treatment modality for esophageal carcinoma. Neoadjuvant chemotherapy in our experience failed to improve these survival rates and pre-operative chemoradiation was associated with a high perioperative mortality rate. Chemotherapy regimens with higher CRs may further improve these survival rates.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 15:13:59