HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Thomas W. Rice Malcolm M. DeCamp Sudish C. Murthy Eugene H. Blackstone Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rice, T. W. Articles by Blackstone, E. H. Search for Related Content PubMed PubMed Citation Articles by Rice, T. W. Articles by Blackstone, E. H. Related Collections Esophagus - cancer

J Thorac Cardiovasc Surg 2003;126:1590-1596
© 2003 The American Association for Thoracic Surgery

General thoracic surgery

Benefit of postoperative adjuvant chemoradiotherapy in locoregionally advanced esophageal carcinoma

^a The Center for Swallowing and Esophageal Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio,USA
^b Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^c Department of Hematology and Medical Oncology,, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^d Department of Radiation Oncology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^e Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Read at the Twenty-eighth Annual Meeting of The Western Thoracic Surgical Association, Big Sky, Mont, June 19-22, 2002.

Received for publication June 20, 2002; revisions received August 19, 2002; revisions received March 11, 2003; accepted for publication April 10, 2003.

^* Address for reprints: Thomas W. Rice, MD, The Cleveland Clinic Foundation, 9500 Euclid Ave/Desk F25, Cleveland, OH 44195, USA
ricet{at}ccf.org

OBJECTIVE: We sought to determine whether chemoradiotherapy after esophagectomy improves survival.

METHODS: From 1994 to 2000, 31 patients with locoregionally advanced esophageal carcinoma (90% pT3, 81% pN1, and 13% pM1a) received postoperative adjuvant chemoradiotherapy. Concurrently, 52 patients with advanced carcinoma underwent esophagectomy alone and survived at least 10 weeks, the time frame for adjuvant therapy. A propensity score based on demographic, tumor, and surgical factors was used to identify matched pairs to determine the association of adjuvant therapy with outcomes.

RESULTS: For patients receiving adjuvant therapy versus esophagectomy alone, risk-unadjusted median, 1-year, and 4-year survivals were 28 versus 14 months, 68% ± 8.4% versus 60% ± 6.8%, and 44% ± 9.0% versus 17% ± 5.6%, respectively (P = .05). Similarly, risk-unadjusted median time to recurrence was 25 versus 13 months (P = .15), and median recurrence-free survival was 22 versus 11 months (P = .04). Among propensity-matched patients, median, 1-year, and 4-year survivals for those receiving adjuvant therapy versus esophagectomy were 28 versus 15 months, 60% ± 11.0% versus 65% ± 10.7%, and 44% ± 11.3% versus 0% (P = .05). Median time to recurrence was 25 versus 13 months (P = .04), and recurrence-free survival was 22 versus 10 months (P = .02).

CONCLUSION: In patients with locoregionally advanced esophageal carcinoma, addition of postoperative adjuvant chemoradiotherapy to esophagectomy alone doubled survival time, time to recurrence, and recurrence-free survival. Patients with locoregionally advanced carcinoma after esophagectomy should be considered for adjuvant therapy.

This article has been cited by other articles:

				B. M. Stiles, P. Christos, J. L. Port, P. C. Lee, S. Paul, J. Saunders, and N. K. Altorki Predictors of survival in patients with persistent nodal metastases after preoperative chemotherapy for esophageal cancer J. Thorac. Cardiovasc. Surg., February 1, 2010; 139(2): 387 - 394. [Abstract] [Full Text] [PDF]

				P. D. DiMusto and M. B. Orringer Transhiatal Esophagectomy for Distal and Cardia Cancers: Implications of a Positive Gastric Margin Ann. Thorac. Surg., June 1, 2007; 83(6): 1993 - 1999. [Abstract] [Full Text] [PDF]

				T. W. Rice, D. P. Mason, S. C. Murthy, G. Zuccaro Jr, D. J. Adelstein, L. A. Rybicki, and E. H. Blackstone T2N0M0 esophageal cancer J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 317 - 324. [Abstract] [Full Text] [PDF]

				T. W. Rice, D. Khuntia, L. A. Rybicki, D. J. Adelstein, M. A. Vogelbaum, D. P. Mason, S. C. Murthy, and E. H. Blackstone Brain Metastases From Esophageal Cancer: A Phenomenon of Adjuvant Therapy? Ann. Thorac. Surg., December 1, 2006; 82(6): 2042 - 2049. [Abstract] [Full Text] [PDF]