Multicenter prospective randomized trial comparing standard esophagectomy with chemoradiotherapy for treatment of squamous esophageal cancer: Early results from the Chinese University Research Group for Esophageal Cancer (CURE)
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AbstractWe conducted a prospective randomized trial to compare the efficacy and survival outcome by chemoradiation with that by esophagectomy as a curative treatment. From July 2000 to December 2004, 80 patients with potentially resectable squamous cell carcinoma of the mid or lower thoracic esophagus were randomized to esophagectomy or chemoradiotherapy. A two- or three-stage esophagectomy with two-field dissection was performed. Patients treated with chemoradiotherapy received continuous 5-fluorouracil infusion (200 mg/m(2)/day) from day I to 42 and cisplatin (60 mg/m(2)) on days 1 and 22. The tumor and regional lymphatics were concomitantly irradiated to a total of 50-60 Gy. Tumor response was assessed by endoscopy, endoscopic ultrasonography, and computed tomography scan. Salvage esophagectomy was performed for incomplete response or recurrence. Forty-four patients received standard esophagectomy, whereas 36 were treated with chemoradiotherapy. Median follow-up was 16.9 months. The operative mortality was 6.8%. The incidence of postoperative complications was 38.6%. No difference in the early cumulative survival was found between the two groups (RR = 0.89; 95% confidence interval, 0.37-2.17; log-rank test P = 0.45). There was no difference in the disease-free survival. Patients treated with surgery had a slightly higher proportion of recurrence in the mediastinum, whereas those treated with chemoradiation sustained a higher proportion of recurrence in the cervical or abdominal regions. Standard esophagectomy or chemoradiotherapy offered similar early clinical outcome and survival for patients with squamous cell carcinoma of the esophagus. The challenge lies in the detection of residue disease after chemoradiotherapy.
All Author(s) ListChiu PWY, Chan ACW, Leung SF, Leong HT, Kwong KH, Li MKW, Au-Yeung ACM, Chung SCS, Ng EKW
Name of Conference19th World Congress of the International-Society-for-Digestive-Surgery
Start Date of Conference08/12/2004
End Date of Conference11/12/2004
Place of ConferenceYokohama
Journal nameJournal of Gastrointestinal Surgery
Volume Number9
Issue Number6
Pages794 - 802
LanguagesEnglish-United Kingdom
Keywordscarcinoma of esophagus; chemoradiation; chemoradiotherapy; esophagectomy; squamous cell carcinoma
Web of Science Subject CategoriesGastroenterology & Hepatology; GASTROENTEROLOGY & HEPATOLOGY; Surgery; SURGERY

Last updated on 2020-27-10 at 02:09