Neoadjuvant therapy of squamous cell carcinoma of the esophagus: role of resection and benefit in partial responders.
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.
Department of Surgery, Mississippi Baptist Medical Center, Jackson.
V L
VL
Lackey
M T
MT
Reagan
R A
RA
Smith
W J
WJ
Anderson
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012074:Remission Induction
D002945:Cisplatin; D005472:Fluorouracil