Preoperative chemoradiotherapy for esophageal cancer: factors associated with clinical response and postoperative complications.
BACKGROUND
The factors associated with the clinical results of preoperative chemoradiotherapy (CRT) for esophageal cancer and its effect on postoperative complications are still unclear.


METHODS
The 686 patients with esophageal cancer were classified into 376 who received preoperative CRT (group I) and 310 who received surgery alone (group II).


RESULTS
A multivariate analysis for group I patients revealed pathologically complete response to be a favorable prognostic factor. Preoperative use of cisplatin was significantly associated with pathological effect and patients' prognosis. Both pulmonary complications and anastomotic leakage more frequently developed in group I (16.0 and 27.9%) than in group II (10.0%, p<0.05 and 16.5%, p<0.01, respectively). A multivariate analysis revealed preoperative CRT to be an independent factor of postoperative complications.


CONCLUSIONS
Although preoperative CRT for esophageal cancer may be associated with postoperative complications, a pathologically complete response, which is associated with a cisplatin-based regimen, is critical for improving patient prognosis.
Morita
Masaru
M
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. masarum@surg2.med.kyushu-u.ac.jp
Masuda
Takanobu
T
Okada
Satoko
S
Yoshinaga
Keiji
K
Saeki
Hiroshi
H
Tokunaga
Eriko
E
Endo
Kazuya
K
Emi
Yasunori
Y
Kakeji
Yoshihiro
Y
Maehara
Yoshihiko
Y
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D002945:Cisplatin