title: [Long-term outcome of neoadjuvant radiochemotherapy followed by surgery for esophageal cancer: a single institution retrospective study of 102 patients].
abstract: OBJECTIVE
  To report survival and morbidity of a large homogeneous cohort of patients with a locally advanced esophageal or cardia carcinoma and put in evidence predictive factors of locoregional control and survival.
  
  
  METHODS
  Hundred and two patients were treated at the university hospital of Tours between 1990 and 2010 and received neo-adjuvant chemoradiation therapy with external irradiation (40Gy-44Gy) and two courses of chemotherapy (5-fluoro-uracile and cisplatine). Esophagectomy associated with lymph node dissection was performed about ten weeks after the end of chemoradiation therapy.
  
  
  RESULTS
  The median follow-up was 22.4 months [6-185 months]. The overall survival rates at 2 and 5years were 53% and 27%, respectively. The median overall survival was estimated at 27months. The overall 2-year survival between patients "responders" and patients "non-responders" was 67% vs 26%, respectively (P<0.0001). In case of histological response, there was a benefit in terms of overall survival (P<0.0001), locoregional control (P<0.0036) and disease-free survival (P<0.001). Overall survival at 2years was 64% for ypN0 group vs 32% for ypN1 group (P<0.0001). The median survival was estimated at 37months against 15months in the absence of lymph node involvement (P<0.0001).
  
  
  CONCLUSIONS
  Our results in terms of survival, tolerance and morbidity and mortality were comparable to those in the literature. Complete histological response of lymph node was associated with an improvement of local control, disease-free survival and overall survival.
authors.affiliation: Clinique d'oncologie-radiothérapie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Ruffier-Loubière
authors.affiliation: Clinique d'oncologie-radiothérapie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France. Electronic address: guillaume.janoray@yahoo.fr.
authors.forename: G
authors.initials: G
authors.lastname: Janoray
authors.affiliation: Clinique d'oncologie-radiothérapie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Chapet
authors.affiliation: Service de chirurgie digestive, hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: de Calan
authors.affiliation: Service de chirurgie thoracique, hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: P
authors.initials: P
authors.lastname: Dumont
authors.affiliation: Service de gastroentérologie, hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: É
authors.initials: É
authors.lastname: Dorval
authors.affiliation: Service d'anatomopathologie, hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: I
authors.initials: I
authors.lastname: Orain
authors.affiliation: Clinique d'oncologie-radiothérapie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Calais
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications; D012189:Retrospective Studies
chemical_list: D002945:Cisplatin; D005472:Fluorouracil
keywords: Cancer de l’œsophage; Esophageal cancer; Neoadjuvant radiochemotherapy; Nodal downstaging; Pathological response; Radiochimiothérapie néoadjuvante; Régression ganglionnaire; Régression tumorale; Réponse histologique; Survie; Survival; Tumor downstaging