title: Chemo-radiotherapy in locally advanced squamous cell oesophageal cancer--are upper third tumours more responsive?
abstract: Before neoadjuvant therapy was widely applied, the prognosis of oesophageal cancer had been considered dependent on the location of the tumor, i.e. upper third cancers had had the worst prognosis. The aim of this retrolective study was to prove the efficiency of the neoadjuvant treatment, and to compare the response of esophageal cancer in different locations. Between January 1998 and September 2005, 102 patients with locally advanced squamous cell oesophageal cancer received preoperative chemo-radiotherapy. In 40 cases the tumor was located in the upper third and in 62 cases in the middle third of the oesophagus. After a four-week-long treatment free period restaging was carried out and patients considered resectable were submitted to surgery. From 40 patients with upper third oesophageal cancer 28 underwent oesophageal resection or pharyngo-laryngectomy. Thiry-five percent a complete histopathological remission was observed. From 62 patients with middle third oesophageal cancer 43 underwent oesophageal resection. Histological examination of the resected specimens documented complete response only in three patients. The median survival and the R0 resection rate were similar in the two groups. Although the resection rate, perioperative morbidity, mortality and the median survival were similar in the two groups, a significantly higher rate of complete response (p < 0,05) was observed in patients with upper third oesophageal cancer compared to patients with middle third oesophageal cancer. It seems that upper third oesophageal cancer has superior sensitivity to multimodal treatment therefore our results may support that upper third location is not an unfavorable prognostic factor any more.
authors.affiliation: Department of Surgery, Medical Faculty, University of Pécs, Hungary, Ifjusag u.13, Pécs, H-7624, Hungary. andras.papp@aok.pte.hu
authors.forename: Andras
authors.initials: A
authors.lastname: Papp
authors.forename: Laszlo
authors.initials: L
authors.lastname: Cseke
authors.forename: Robert
authors.initials: R
authors.lastname: Farkas
authors.forename: Gabor
authors.initials: G
authors.lastname: Pavlovics
authors.forename: Gabor
authors.initials: G
authors.lastname: Horvath
authors.forename: Gabor
authors.initials: G
authors.lastname: Varga
authors.forename: Andras
authors.initials: A
authors.lastname: Szigeti
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Bellyei
authors.forename: Sandor
authors.initials: S
authors.lastname: Marton
authors.forename: Laszlo
authors.initials: L
authors.lastname: Poto
authors.forename: Katalin
authors.initials: K
authors.lastname: Kalmar
authors.forename: Andras
authors.initials: A
authors.lastname: Vereczkei
authors.forename: Eva
authors.initials: E
authors.lastname: Pozsgai
authors.forename: Ors Peter
authors.initials: OP
authors.lastname: Horvath
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents