title: Clinical significance of chemoradiotherapy and surgical resection for cT4 esophageal cancer.
abstract: OBJECTIVE
  To clarify the clinical significance of definitive chemoradiotherapy (CRT) and CRT followed by esophagectomy for cT4 esophageal cancer.
  
  
  METHODS
  The treatment results for cT4 esophageal cancer were examined in 81 patients who received definitive CRT [radiation 50-70 Gy, cisplatin and 5-fluorouracil; group I] and 19 patients who underwent esophagectomy after preoperative CRT [40Gy, Group II].
  
  
  RESULTS
  Among the 81 patients in group I, toxicities (grade 3 or 4) were observed in 32 patients, while partial response and complete response were recognized in 8 and 47 patients, respectively. Of the 19 group II patients, an R0 resection was performed in 16 patients, and the mortality rate was 5%. The 5-year survival rates were 19% and 42% in groups I and II, respectively.
  
  
  CONCLUSIONS
  Long-term survival can be expected after multimodal therapy, even for patients with cT4 esophageal cancer. Esophagectomy is therefore a valid treatment option when down-staging can be achieved.
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. masarum@surg2.med.kyushu-u.ac.jp
authors: Masaru
authors: M
authors: Morita
authors: Yasushi
authors: Y
authors: Toh
authors: Hiroshi
authors: H
authors: Saeki
authors: Masahiko
authors: M
authors: Sugiyama
authors: Kippei
authors: K
authors: Ohgaki
authors: Shin-Ichiro
authors: S
authors: Maehara
authors: Kazuhito
authors: K
authors: Minami
authors: Yasuharu
authors: Y
authors: Ikeda
authors: Yoshihisa
authors: Y
authors: Sakaguchi
authors: Takeshi
authors: T
authors: Okamura
authors: Satoru
authors: S
authors: Uehara
authors: Yoshihiko
authors: Y
authors: Maehara
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil