title: Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T(2-3)N(any) M(0) squamous cell carcinoma of the esophagus.
abstract: OBJECTIVE
  To compare the treatment results between radical surgery and definitive chemoradiotherapy for resectable squamous cell carcinoma of the esophagus and to identify useful clinicopathologic and biologic markers to select better treatment.
  
  
  METHODS
  Between August 1992 and April 1999, 98 consecutive patients were selected for this study; 53 were treated with chemoradiotherapy and 45 with surgery. The patients in the chemoradiotherapy group received 5-fluorouracil combined with cisplatin plus 60 Gy of radiation, and those in the surgery group received an esophagectomy with radical node dissection. Biologic markers were investigated immunohistochemically using pretreatment biopsy specimens.
  
  
  RESULTS
  The baseline clinical TNM stage was more advanced in the chemoradiotherapy group than in the surgery group. With a median follow-up period of 43 months, the 5-year survival rate was 46% in the chemoradiotherapy and 51% in the surgery group, without statistical significance (p = 0.47, log-rank test). Cox regression analysis for prognosis revealed that epidermal growth factor receptor positivity, high microvessel density, and cyclin D1 positivity yielded a low value for relative risk (0.66, 0.54, and 0.62, respectively), which favored chemoradiotherapy over surgery, without statistical significance.
  
  
  CONCLUSIONS
  This nonrandomized study showed a trend for the chemoradiotherapy in the treatment of esophageal carcinoma, but the results need to be confirmed by additional study.
authors.affiliation: Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. s.hironaka@scchr.jp
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hironaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohtsu
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
authors.forename: Fumio
authors.initials: F
authors.lastname: Nagashima
authors.forename: Hiroki
authors.initials: H
authors.lastname: Saito
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Yoshida
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Nishimura
authors.forename: Masatora
authors.initials: M
authors.lastname: Haruno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishikura
authors.forename: Takashi
authors.initials: T
authors.lastname: Ogino
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ochiai
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001835:Body Weight; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004435:Eating; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D002945:Cisplatin; D005472:Fluorouracil