Clinical and Oncological Effects of Triplet Chemotherapy Followed by Radical Esophagectomy for Resectable Esophageal Cancer Associated with Unfavorable Prognostic Factors

Overview

Journal Surg Today

Specialty General Surgery

Date 2013 Aug 22

PMID 23963503

Citations 4

Authors

Hideaki Shimoji

Tatsuya Kinjo

Hiroyuki Karimata

Masayoshi Nagahama

Tadashi Nishimaki

Affiliations

Soon will be listed here.

Abstract

Purposes: The purpose of this study was to evaluate the hypothesis that the survival of patients undergoing R0 resection after triplet chemotherapy for resectable esophageal cancer with unfavorable prognostic factors (Category 3) would be similar to that of patients undergoing esophagectomy for esophageal cancer without such factors (Category 1).

Methods: Patients with Category 3 tumors were assigned to receive triplet chemotherapy consisting of 5-fluorouracil, doxorubicin and nedaplatin (FAN) followed by radical esophagectomy. The outcomes of the bimodality treatment for Category 3 patients (n = 25) were compared with those of Category 1 patients (n = 41) in a prospective cohort study.

Results: Grade 3 or higher toxicity developed during chemotherapy in 32 % of the Category 3 patients, with no treatment-related deaths. No significant difference was detected in the surgery-related mortality and morbidity rates between the two groups. The recurrence-free survival was significantly worse in Category 3 than in Category 1 patients (p = 0.002), although the overall survival was not significantly different (p = 0.085) between the two groups in cases of R0 resection (5-year survival rates: 34.4 vs. 66.5 %).

Conclusions: Although FAN chemotherapy followed by radical esophagectomy can be safely performed, this treatment modality may not have sufficient power to cure Category 3 disease.

Citing Articles

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Saeki H, Nakashima Y, Zaitsu Y, Tsuda Y, Kasagi Y, Ando K Surg Today. 2015; 46(3):261-7.

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Clinicopathological factors predicting R0 resection and long-term survival after esophagectomy in patients with T4 esophageal cancer undergoing induction chemotherapy or chemoradiotherapy.

Karimata H, Shimoji H, Nishimaki T Surg Today. 2014; 45(4):479-86.

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Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities.

Napier K, Scheerer M, Misra S World J Gastrointest Oncol. 2014; 6(5):112-20.

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