| Theme |
Current Status of Uprising Strategy for Esophageal Cancer Treatment |
| Title |
First Line Treatment for Esophageal Cancer : Comparison of Clinical Outcomes of Definitive Chemoradiotherapy Followed by Salvage Treatment and Surgery Alone |
| Author |
Takashi Kamei |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| Author |
Go Miyata |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| Author |
Ko Onodera |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| Author |
Hirofumi Ichikawa |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| Author |
Hiroshi Kikuchi |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| Author |
Toru Nakano |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| Author |
Susumu Satomi |
Division of Surgical Science and Technology, Graduate School of Medicine, Tohoku University |
| [ Summary ] |
In recent years, there have been some reports which have indicated definitive chemoradiotherapy (CRT) provides good clinical outcomes, which are comparable to surgery for esophageal cancer patients. Successful CRT has the remarkable benefit of organ preservation and achieves good quality of life. In 2001 we initiated CRT followed by salvage treatment for resectable cases (cStage I, II, III except T4, any N) and compared clinical results to those achieved in patients who underwent surgery alone in the same period. Overall survival rates for patients who received CRT alone and those who underwent surgery showed no significant differences in cancer staging. However, salvage treatment is clearly essential to achieve adequate clinical outcomes for patients who receive CRT. The majority of patients with cStage I and IIB conditions had continuous complete response (CR) or were treated with salvage ESD as a second line therapy. They received the benefits of esophageal preservation also. In contrast, many patients with cStage III disease had residual diseases after CRT. Therefore, salvage esophagectomy is needed as a second line therapy. It is thought cStage I and IIB cancers are good indicators for CRT. However, those treatments may be of limited usefulness for patients with cStage IIA and III conditions. |