Neoadjuvant therapy for esophageal cancer--what can we accept?
OBJECTIVE
We evaluated neoadjuvant use in managing patients with esophageal carcinoma and its effects on the surgical resection and outcomes.


METHODS
Patients prior to esophageal resection were offered the opportunity to receive a neoadjuvant cytostatic regimen (CDDP + FU, CDDP, or TAX + FU). Retrospective tumor chemoresistance analysis using the MTT test was also performed.


RESULTS
Seventy patients were operated from 2001 until May 2004. A total of 55 resections were performed with preoperative neoadjuvant therapy and 15 elected to only undergo surgery without neoadjuvant therapy. No deaths occurred as a result of surgery or neoadjuvant therapy, but complications included fistulas and hemorrhages.


CONCLUSIONS
There was no significant difference between the postoperative complications among the neoadjuvant and non-neoadjuvant groups. This therapy therefore does not have any influence on the course or results of surgical resection. MTT testing did not demonstrate any particular usefulness in tailoring neoadjuvant therapy. Chemoresistance could only be retrospectively evaluated and the results may be affected after cytostatic therapy. The long-term outcomes have not been evaluated yet due to the short follow-up time in our patient group.
Krdál
Vladimír
V
1st Department of Surgery, Palacky University Teaching Hospital, Olomouc, Czech Republic. vladimirkral@fnol.cz
Neoral
Cestmír
C
Aujesky
René
R
Havlík
Roman
R
Klein
Jirí
J
Hajdúch
Marian
M
Svébisová
Hana
H
Benes
Petr
P
Vrba
Radek
R
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies
D002945:Cisplatin; D005472:Fluorouracil