A combined modality approach to the management of oesophageal cancer

Smithers, B. Mark, Devitt, Peter, Jamieson, Glyn G., Bessell, Justin, Gotley, David, Gill, P. Grantley, Neely, Mervyn, Joseph, David J., Yeoh, Eric K., Burmeister, Bryan and Denham, James W. (1997) A combined modality approach to the management of oesophageal cancer. European Journal of Surgical Oncology, 23 3: 219-223. doi:10.1016/S0748-7983(97)92364-7


Author Smithers, B. Mark
Devitt, Peter
Jamieson, Glyn G.
Bessell, Justin
Gotley, David
Gill, P. Grantley
Neely, Mervyn
Joseph, David J.
Yeoh, Eric K.
Burmeister, Bryan
Denham, James W.
Title A combined modality approach to the management of oesophageal cancer
Journal name European Journal of Surgical Oncology   Check publisher's open access policy
ISSN 0748-7983
1532-2157
Publication date 1997-06
Sub-type Article (original research)
DOI 10.1016/S0748-7983(97)92364-7
Volume 23
Issue 3
Start page 219
End page 223
Total pages 5
Place of publication London, United Kingdom
Publisher W.B. Saunders
Language eng
Formatted abstract This study aims to update the experience of multimodality approaches in the management of oesophagealcancer that have been adopted in several Australian and New Zealand hospitals. Between 1984 and 1985, 92 patients received preoperative radiotherapy (30–36 Gy over 3 weeks) and one of two chemotherapy regimes (one or two courses of i.v. cisplatin 80 mg/m2 plus a 4–5 day continuous i.v. of fluorouracil 5–800 mg/m2/day) concurrently prior to surgery. Eighty-two patients (89%) underwent resection as planned. Operative specimens were microscopically free of residual tumour in 18 patients. Eight patients (9%) had treatment-related deaths: seven from surgery and one due to pre-operative chemoradiation. The Kaplan-Meier 5-year cause-specific survival estimates were 32.9 ± 7.8% for the 58 patients with squamous cancer and 0% for the 32 with adenocarcinoma. Complete pathological response to the pre-operative regime was more common in females and was associated with a survival advantage. Five-year cause-specific survival expectation in patients who experienced a complete pathological response was 71.5 ± 12.4%, whereas it was only 15.9 ± 5.6% in patients who had residual cancer in their surgical specimens. Although less toxic the pre-operative regime utilizing only one cycle of chemotherapy was no less efficacious either in producing a complete pathological response or in terms of survival expectation. This uncontrolled pilot study has produced encouraging long-term results, especially for patients with squamous carcinoma that experienced a complete response to pre-operative synchronous chemoradiotherapy. A randomized controlled study comparing surgery alone with (one cycle) chemoradiation followed by surgery is now underway.
Keyword Oesophagus cancer
Oesophagectomy
Pre-operative therapy
Neo-adjuvant therapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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