| Theme | Clinical Management of Esophageal Cancer 2017 -- Current Status and Issues | |
|---|---|---|
| Title | Perioperative Adjuvant Therapy for Resectable Esophageal Squamous Cell Carcinoma -- Preoperative and Postoperative Adjuvant Therapy | |
| Publish Date | 2017/08 | |
| Author | Koichi Yagi | Department of Gastrointestinal Surgery, The University of Tokyo |
| Author | Yasuyoshi Sato | Department of Gastrointestinal Surgery, The University of Tokyo |
| Author | Masato Nishida | Department of Gastrointestinal Surgery, The University of Tokyo |
| Author | Hiroharu Yamashita | Department of Gastrointestinal Surgery, The University of Tokyo |
| Author | Sachiyo Nomura | Department of Gastrointestinal Surgery, The University of Tokyo |
| Author | Yasuyuki Seto | Department of Gastrointestinal Surgery, The University of Tokyo |
| [ Summary ] | Surgical resection is a major therapeutic modality for resectable esophageal squamous cell carcinoma (ESCC). Moreover, surgical resection combined with perioperative adjuvant therapy results in higher overall survival (OS) compared with surgery alone. In Japan, the JCOG9204 trial revealed that surgery + postoperative adjuvant chemotherapy using cisplatin (CDDP) + 5‒FU (CF, FP) improved disease‒free survival compared with surgery alone, particularly in cases with lymph node metastasis. Meanwhile, the JCOG9907 trial revealed that neoadjuvant chemotherapy (NAC) with CF + surgery improved overall survival compared with surgery + postoperative adjuvant chemotherapy with CF. Currently, NAC with CF + esophagectomy is a standard treatment for resectable clinical stage II/III ESCC. In Western countries, both NAC and neoadjuvant chemoradiotherapy (NACRT) followed by surgery had been shown to improve OS compared with surgery alone and such modalities are considered as a standard treatment. Meta‒analysis revealed that NAC and NACRT do not increase perioperative complications. At present, the JCOG 1109 trial, which is a three‒arm phase III trial investigating the superiority of docetaxel + CF to CF and the superiority of CF with radiotherapy to CF as an neoadjuvant therapy, is undergoing. | |