Original articleGeneral thoracicInduction Chemoradiotherapy and Surgery for Esophageal Cancer: Survival Benefit With Downstaging
Section snippets
Patient Selection
A retrospective analysis of a prospectively maintained General Thoracic Surgery Database at the University of Virginia from July 1999 through August 2011 was performed. The University of Virginia General Thoracic Surgery Database is maintained by the Division of Thoracic and Cardiovascular Surgery and includes all data fields contained within the Society of Thoracic Surgery's General Thoracic Surgery Database in addition to other important clinicopathologic variables. All standardized variables
Results
The demographic characteristics of the population are shown in Table 1. There were 189 patients included in the surgery alone group and 180 patients who underwent induction chemoradiation therapy followed by surgery. Median follow-up was 918 days (range, 3 to 4,831 days). Patients undergoing induction therapy followed by surgery were younger compared with patients who underwent surgery alone. There were equal proportions of male to female ratios in both treatment groups. Average length of stay
Comment
This study compares perioperative and postoperative outcomes between patients undergoing surgery alone versus patients receiving induction chemoradiation therapy followed by esophagectomy using a propensity-matched model to control for key clinical variables. Induction chemoradiation therapy was associated with an increased need for postoperative blood transfusion and wound infection rates. Subgroup analysis revealed a significant improvement in 3- and 5-year survival rates in clinical stage
References (14)
- et al.
Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial
Lancet Oncol
(2005) - et al.
A single institutional phase III trial of preoperative chemotherapy with hyperfractionation radiotherapy plus surgery versus surgery alone for resectable esophageal squamous cell carcinoma
Ann Oncol
(2004) - et al.
Preoperative chemoradiation therapy does not improve early survival after esophagectomy for patients with clinical stage III adenocarcinoma of the esophagus
Ann Thorac Surg
(2004) - et al.
Morbidity and mortality after esophagectomy following neoadjuvant chemoradiation
Ann Thorac Surg
(2011) - et al.
Downstaging of T or N predicts long-term survival after preoperative chemotherapy and radical resection for esophageal carcinoma
Ann Thorac Surg
(2006) - Howlader N, Noone AM, Krapcho M, et al, eds. SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations),...
- et al.
Concurrent cisplatin, paclitaxel, and radiotherapy as preoperative treatment for patients with locoregional esophageal carcinoma
Cancer
(2003)
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