Pennathur A et al. - In a study to assess the use of neoadjuvant chemotherapy, followed by esophagectomy and adjuvant chemotherapy for potentially resectable esophageal carcinoma, the study demonstrates encouraging long-term results. Downstaging of the tumor with preoperative chemotherapy is predictive of better long-term outcome Methods
Pts were staged with computed tomography scan, endoscopic ultrasonography, and laparoscopy with or without thoracoscopy
Pretreatment stages were T2N0 in 1, T2N1 in 15, T3N0 in 13, and T3N1 in 41
Chemotherapy consisted of 2 or 3 cycles of cisplatin, 5-fluorouracil, and paclitaxel followed by esophagectomy and adjuvant chemotherapy
Pts were monitored for recurrence and survival
Results
70 pts were enrolled: 66 adenocarcinoma, 4 squamous cell carcinoma; 64 men and 6 women; median age, 60 years
Esophagectomy was performed in 63 pts
Operative mortality was 0%
Median overall survival (OS) of the entire group was 27.4 months
17 pts were alive at a median follow-up of 62.8 months; 14 pts were alive without recurrence at a median of 79 months
Nodal status was an important predictor of OS
Pts who were downstaged experienced a significantly improved median survival of 63.4 months vs 21.5 months and OS
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