title: [The role of neoadjuvant therapy in the treatment of locally advanced squamous cell cancer of the cervical oesophagus].
abstract: BACKGROUND
  Cervical oesophagus represents a critical location for squamous cell carcinoma, which usually requires extensive surgery (pharyngo-laryngo-oesophagectomy). In the last decade, neoadjuvant chemo-radiotherapy was reported to be beneficial in the treatment of locally advanced squamous cell oesophageal cancer.
  
  
  METHODS
  Between November 1997 and January 2012, 55 patients with locally advanced (T3-4) squamous cell oesophageal cancer received preoperative chemo-radiotherapy, where the tumour was localized in the upper third. Patients received preoperative irradiation of 3960 cGy in 180 cGy fractions and simultaneously Cisplatin and 5-FU chemotherapy. Restaging was carried out after four weeks and patients considered operable were underwent surgery.
  
  
  RESULTS
  In patients with cervical oesophageal cancer 35 of 55 (64%) underwent oesophageal resection or pharyngo-laryngectomy. In 16 out of 35 resected specimens (46%) complete histopathological remission (pCR) was observed. Perioperative mortality and anastomotic leaks were the same: 5/35 (14%). R0 resection rate was 82% and the 2- and 5 years survival rates were 41% and 18%. In 19 cases a larynx preserving pharyngo-oesophagectomy was performed and a free jejunal graft was used for reconstruction after a pharyngo-laryngectomy in 11 cases.
  
  
  CONCLUSIONS
  The high rate of pCR (46%) confirmed that upper third oesophageal cancer has superior sensitivity to multimodal treatment. In 30 cases neoadjuvant chemo-radiotherapy was able to achieve tumour regression and render pharyngo-laryngo-oesophagectomy unnecessary.
authors.affiliation: Pécsi Tudományegyetem Klinikai Központ, Sebészeti Klinika 7624 Pécs Rákóczi u. papp.andras@pte.hu
authors.forename: András
authors.initials: A
authors.lastname: Papp
authors.forename: László
authors.initials: L
authors.lastname: Cseke
authors.forename: Gábor
authors.initials: G
authors.lastname: Varga
authors.forename: Gábor
authors.initials: G
authors.lastname: Pavlovics
authors.forename: László
authors.initials: L
authors.lastname: Potó
authors.forename: Sándor
authors.initials: S
authors.lastname: Márton
authors.forename: Róbert
authors.initials: R
authors.lastname: Farkas
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Bellyei
authors.forename: Ors Péter
authors.initials: OP
authors.lastname: Horváth
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D007825:Laryngectomy; D007902:Length of Stay; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D010611:Pharyngectomy; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil