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- Publisher Website: 10.1016/S0022-5223(97)70147-8
- Scopus: eid_2-s2.0-0030755829
- PMID: 9270638
- WOS: WOS:A1997XR34200009
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Article: Preoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: A prospective randomized trial
Title | Preoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: A prospective randomized trial |
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Authors | |
Issue Date | 1997 |
Publisher | Mosby, 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? |
Abstract | Objective: 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 Identifier | http://hdl.handle.net/10722/83753 |
ISSN | 2023 Impact Factor: 4.9 2023 SCImago Journal Rankings: 1.744 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Law, S | en_HK |
dc.contributor.author | Fok, M | en_HK |
dc.contributor.author | Chow, S | en_HK |
dc.contributor.author | Chu, KM | en_HK |
dc.contributor.author | Wong, J | en_HK |
dc.date.accessioned | 2010-09-06T08:44:48Z | - |
dc.date.available | 2010-09-06T08:44:48Z | - |
dc.date.issued | 1997 | en_HK |
dc.identifier.citation | Journal Of Thoracic And Cardiovascular Surgery, 1997, v. 114 n. 2, p. 210-117 | en_HK |
dc.identifier.issn | 0022-5223 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/83753 | - |
dc.description.abstract | Objective: 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.language | eng | en_HK |
dc.publisher | Mosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvs | en_HK |
dc.relation.ispartof | Journal of Thoracic and Cardiovascular Surgery | en_HK |
dc.rights | The Journal of Thoracic and Cardiovascular Surgery. Copyright © Mosby, Inc. | en_HK |
dc.title | Preoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: A prospective randomized trial | en_HK |
dc.type | Article | en_HK |
dc.identifier.openurl | http://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+trial | en_HK |
dc.identifier.email | Law, S: slaw@hku.hk | en_HK |
dc.identifier.email | Chow, S: spchow@hku.hk | en_HK |
dc.identifier.email | Chu, KM: chukm@hkucc.hku.hk | en_HK |
dc.identifier.email | Wong, J: jwong@hkucc.hku.hk | en_HK |
dc.identifier.authority | Law, S=rp00437 | en_HK |
dc.identifier.authority | Chow, S=rp00064 | en_HK |
dc.identifier.authority | Chu, KM=rp00435 | en_HK |
dc.identifier.authority | Wong, J=rp00322 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/S0022-5223(97)70147-8 | en_HK |
dc.identifier.pmid | 9270638 | - |
dc.identifier.scopus | eid_2-s2.0-0030755829 | en_HK |
dc.identifier.hkuros | 32368 | en_HK |
dc.identifier.volume | 114 | en_HK |
dc.identifier.issue | 2 | en_HK |
dc.identifier.spage | 210 | en_HK |
dc.identifier.epage | 117 | en_HK |
dc.identifier.isi | WOS:A1997XR34200009 | - |
dc.publisher.place | United States | en_HK |
dc.identifier.scopusauthorid | Law, S=7202241293 | en_HK |
dc.identifier.scopusauthorid | Fok, M=7005879262 | en_HK |
dc.identifier.scopusauthorid | Chow, S=7201828376 | en_HK |
dc.identifier.scopusauthorid | Chu, KM=7402453538 | en_HK |
dc.identifier.scopusauthorid | Wong, J=8049324500 | en_HK |
dc.identifier.issnl | 0022-5223 | - |