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Article: Preoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: A prospective randomized trial

TitlePreoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: A prospective randomized trial
Authors
Issue Date1997
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvs
Citation
Journal Of Thoracic And Cardiovascular Surgery, 1997, v. 114 n. 2, p. 210-117 How to Cite?
AbstractObjective: This study investigated the role of preoperative chemotherapy in squamous cell cancer of the esophagus. Methods: A prospective randomized trial was undertaken in 147 patients: 74 received preoperative chemotherapy comprising cisplatin and 5-fluorouracil and 73 had surgical therapy alone. End points were cancer and therapy-related deaths. Results: Sixty-six patients (89%) in the chemotherapy group underwent resection compared with 69 (95%) in the control group (p = not significant). Of the 60 patients who had resection after completing the chemotherapy program, 35 (58%) had a significant response, of whom four (6.7%) had a complete pathologic response. Postoperative mortality rates were 8.3% and 8.7% in the chemotherapy and control groups, respectively (p = not significant). Significant downstaging was evident with chemotherapy; curative resections were possible in 67% of these patients compared with 35% in the control group (p = 0.0003). T3 and T4 tumors were found in 67% and 91% of the chemotherapy and control groups, respectively (p = 0.0002). The respective figures for N1 disease were 70% and 88% [p = 0.009). An intent-to-treat analysis of survival showed no significant difference between the two groups. Median survivals were 16.8 and 13 months, respectively (p = 0.17). Of those who completed the chemotherapy and resection, responders fared better than control patients. Median survivals were 42.2 months and 13.8 months, respectively (p = 0.003). Median survival (8.3 months) was worse for nonresponders than for control patients (p = 0.03). The recurrence pattern suggested a significant reduction in locoregional disease with chemotherapy. Conclusions: Preoperative chemotherapy was safe and resulted in significant downstaging and an increased likelihood of curative resection. Survival was not better than that in the surgery-alone group, but responders did fare better than nonresponders.
Persistent Identifierhttp://hdl.handle.net/10722/83753
ISSN
2015 Impact Factor: 3.494
2015 SCImago Journal Rankings: 2.369
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorFok, Men_HK
dc.contributor.authorChow, Sen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:44:48Z-
dc.date.available2010-09-06T08:44:48Z-
dc.date.issued1997en_HK
dc.identifier.citationJournal Of Thoracic And Cardiovascular Surgery, 1997, v. 114 n. 2, p. 210-117en_HK
dc.identifier.issn0022-5223en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83753-
dc.description.abstractObjective: This study investigated the role of preoperative chemotherapy in squamous cell cancer of the esophagus. Methods: A prospective randomized trial was undertaken in 147 patients: 74 received preoperative chemotherapy comprising cisplatin and 5-fluorouracil and 73 had surgical therapy alone. End points were cancer and therapy-related deaths. Results: Sixty-six patients (89%) in the chemotherapy group underwent resection compared with 69 (95%) in the control group (p = not significant). Of the 60 patients who had resection after completing the chemotherapy program, 35 (58%) had a significant response, of whom four (6.7%) had a complete pathologic response. Postoperative mortality rates were 8.3% and 8.7% in the chemotherapy and control groups, respectively (p = not significant). Significant downstaging was evident with chemotherapy; curative resections were possible in 67% of these patients compared with 35% in the control group (p = 0.0003). T3 and T4 tumors were found in 67% and 91% of the chemotherapy and control groups, respectively (p = 0.0002). The respective figures for N1 disease were 70% and 88% [p = 0.009). An intent-to-treat analysis of survival showed no significant difference between the two groups. Median survivals were 16.8 and 13 months, respectively (p = 0.17). Of those who completed the chemotherapy and resection, responders fared better than control patients. Median survivals were 42.2 months and 13.8 months, respectively (p = 0.003). Median survival (8.3 months) was worse for nonresponders than for control patients (p = 0.03). The recurrence pattern suggested a significant reduction in locoregional disease with chemotherapy. Conclusions: Preoperative chemotherapy was safe and resulted in significant downstaging and an increased likelihood of curative resection. Survival was not better than that in the surgery-alone group, but responders did fare better than nonresponders.en_HK
dc.languageengen_HK
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvsen_HK
dc.relation.ispartofJournal of Thoracic and Cardiovascular Surgeryen_HK
dc.rightsThe Journal of Thoracic and Cardiovascular Surgery. Copyright © Mosby, Inc.en_HK
dc.titlePreoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: A prospective randomized trialen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0022-5223&volume=114&spage=210&epage=217&date=1997&atitle=Preoperative+chemotherapy+versus+surgical+therapy+alone+for+squamous+cell+carcinoma+of+the+esophagus:+a+prospective+randomized+trialen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailChow, S: spchow@hku.hken_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityChow, S=rp00064en_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0022-5223(97)70147-8en_HK
dc.identifier.pmid9270638-
dc.identifier.scopuseid_2-s2.0-0030755829en_HK
dc.identifier.hkuros32368en_HK
dc.identifier.volume114en_HK
dc.identifier.issue2en_HK
dc.identifier.spage210en_HK
dc.identifier.epage117en_HK
dc.identifier.isiWOS:A1997XR34200009-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridFok, M=7005879262en_HK
dc.identifier.scopusauthoridChow, S=7201828376en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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