Show simple item record

dc.contributor.authorTamim, Wael Z.
dc.contributor.authorDavidson, Robert S.
dc.contributor.authorQuinlan, Robert M.
dc.contributor.authorO'Shea, Michael A.
dc.contributor.authorOrr, Richard K.
dc.contributor.authorSwanson, Richard S.
dc.date2022-08-11T08:09:43.000
dc.date.accessioned2022-08-23T16:40:53Z
dc.date.available2022-08-23T16:40:53Z
dc.date.issued1998-08-04
dc.date.submitted2008-03-26
dc.identifier.citation<p>Arch Surg. 1998 Jul;133(7):722-6.</p>
dc.identifier.issn0004-0010 (Print)
dc.identifier.doi10.1001/archsurg.133.7.722
dc.identifier.pmid9687999
dc.identifier.urihttp://hdl.handle.net/20.500.14038/39772
dc.description.abstractBACKGROUND: With promising results from several institutions, many centers began treating patients with esophageal cancer with neoadjuvant chemoradiotherapy (NC) followed by esophagectomy. This approach is demanding for the patient and has not been proved to be better than esophagectomy alone. OBJECTIVE: To assess survival time and measures of quality of life associated with NC. DESIGN: A retrospective review during 1990 to 1996. SETTING: The 3 tertiary academic hospitals affiliated with the University of Massachusetts Medical School, Worcester. PARTICIPANTS: All patients (N=51) with cancer of the middle or lower esophagus who were treated with NC followed by esophagectomy during this period. MAIN OUTCOME MEASURES: Median and 1-, 2-, and 3-year survival times; median preoperative treatment time (first office visit for surgical consultation before beginning NC to the date of surgery), median hospital stay, and postoperative swallowing function. RESULTS: The median survival time of all patients was 16.3 months; 1-, 2-, and 3-year overall survival rates were 67%, 46%, and 39%, respectively. The median hospital stay was 12 days. The median postoperative treatment time was 3.3 months, which was 20% of the median survival time. Of the 51 patients, 19 were alive with a median follow-up time of 2.5 years. Twenty-nine percent of the patients had a complete pathological response with median and 1-, 2-, and 3-year survival rates of 17.5 months, 73%, 57%, and 57%, respectively. Palliation of dysphagia was excellent, with 44 (93%) of 47 operative survivors taking either a soft diet (18 [38%]) or a regular (26 [55%]) diet by the first postoperative visit. CONCLUSIONS: Median survival time with NC followed by esophagectomy for resectable cancer of the esophagus does not appear to be significantly better than that reported for esophagectomy alone. Further, treatment time with NC consumed 20% of survival time. Examining only these outcome variables suggests that NC is not worth-while. However, examining a longer-term outcome survival variable, such as 3-year survival time, suggests that NC followed by esophagectomy may result in greater long-term survival than that reported for esophagectomy alone. We conclude that further randomized, controlled studies are necessary before NC followed by esophagectomy is considered superior to esophagectomy alone for the treatment of resectable esophageal cancer.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9687999&dopt=Abstract ">Link to article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1001/archsurg.133.7.722
dc.subjectAdenocarcinoma
dc.subjectCarcinoma, Squamous Cell
dc.subjectChemotherapy, Adjuvant
dc.subjectEsophageal Neoplasms
dc.subjectEsophagectomy
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectMiddle Aged
dc.subject*Quality of Life
dc.subjectRadiotherapy, Adjuvant
dc.subjectRetrospective Studies
dc.subjectSurvival Rate
dc.subjectLife Sciences
dc.subjectMedicine and Health Sciences
dc.titleNeoadjuvant chemoradiotherapy for esophageal cancer: is it worthwhile
dc.typeJournal Article
dc.source.journaltitleArchives of surgery (Chicago, Ill. : 1960)
dc.source.volume133
dc.source.issue7
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/257
dc.identifier.contextkey472831
html.description.abstract<p>BACKGROUND: With promising results from several institutions, many centers began treating patients with esophageal cancer with neoadjuvant chemoradiotherapy (NC) followed by esophagectomy. This approach is demanding for the patient and has not been proved to be better than esophagectomy alone. OBJECTIVE: To assess survival time and measures of quality of life associated with NC. DESIGN: A retrospective review during 1990 to 1996. SETTING: The 3 tertiary academic hospitals affiliated with the University of Massachusetts Medical School, Worcester. PARTICIPANTS: All patients (N=51) with cancer of the middle or lower esophagus who were treated with NC followed by esophagectomy during this period. MAIN OUTCOME MEASURES: Median and 1-, 2-, and 3-year survival times; median preoperative treatment time (first office visit for surgical consultation before beginning NC to the date of surgery), median hospital stay, and postoperative swallowing function. RESULTS: The median survival time of all patients was 16.3 months; 1-, 2-, and 3-year overall survival rates were 67%, 46%, and 39%, respectively. The median hospital stay was 12 days. The median postoperative treatment time was 3.3 months, which was 20% of the median survival time. Of the 51 patients, 19 were alive with a median follow-up time of 2.5 years. Twenty-nine percent of the patients had a complete pathological response with median and 1-, 2-, and 3-year survival rates of 17.5 months, 73%, 57%, and 57%, respectively. Palliation of dysphagia was excellent, with 44 (93%) of 47 operative survivors taking either a soft diet (18 [38%]) or a regular (26 [55%]) diet by the first postoperative visit. CONCLUSIONS: Median survival time with NC followed by esophagectomy for resectable cancer of the esophagus does not appear to be significantly better than that reported for esophagectomy alone. Further, treatment time with NC consumed 20% of survival time. Examining only these outcome variables suggests that NC is not worth-while. However, examining a longer-term outcome survival variable, such as 3-year survival time, suggests that NC followed by esophagectomy may result in greater long-term survival than that reported for esophagectomy alone. We conclude that further randomized, controlled studies are necessary before NC followed by esophagectomy is considered superior to esophagectomy alone for the treatment of resectable esophageal cancer.</p>
dc.identifier.submissionpathoapubs/257
dc.contributor.departmentDepartment of Surgery
dc.source.pages722-6


This item appears in the following Collection(s)

Show simple item record