Korean J Gastroenterol.  2009 Jan;53(1):15-22.

Concurrent Chemoradiotherapy Compared with Concurrent Chemoradiotherapy with Surgery in Locally Advanced Resectable Esophageal Cancer

• Choi YA
• Kim HG
• Jung S
• Lee DH
• Lee JI
• Lee JW
• Park JY
• Shin YW
• Kim YS
• Kim KH
• Yun YH
• No JK
• Kim CS

Abstract

BACKGROUND/AIMS: This study was designed to compare the survival rates between patients with localized esophgeal cancer who were treated with concurrent chemoradiation therapy without surgery and patients who were treated with concurrent chemoradiation therapy including surgery.
METHODS
Eighty-eight patients from January 1997 to December 2005 with locally advaned resectable esophageal cancer were selected and retrospectively analyzed. Survival period was defined as the time to death from the date of diagnosis or mid-monitor period of December 2005. Sixty-one patients were treated with chemoradiation therapy alone while twenty-seven patients were treated with chemoradiation therapy in addition to surgery as for curative intention. As for radiation therapy, 5,000-5,500 cGY was used. 5-Fluouracil and cisplatin were used for chemotherapy. The primary end point was overall survival time. The secondary end point was overall progression free survival time.
RESULTS
There was no significant difference in tissue type, location and clinical staging, but the median age was significantly younger in the group treated with surgery (63.4 years) than the group treated without surgery (68.8 years). Median period analyzed was 17.3 months. Five year survival rate for the group with chemoradiation alone was 7.4% and 4% for the group with surgery. The median survival rate was 11+/-3 months for the group with chemoradiation alone and 10+/-6 months for the group with surgery, in which there was no statistical difference (p=0.697).
CONCLUSIONS
There was no significant increase in survival rate in patients who were treated by chemoradiation with surgery compared with chemoradiation alone. Further analysis in terms of prospective study is needed.

Keyword

Localized esophageal cancer; Concurrent chemoradiotherapy; Surgery; Survival rate

MeSH Terms

Aged
Aged, 80 and over
Antineoplastic Agents/therapeutic use
Combined Modality Therapy
Data Interpretation, Statistical
Esophageal Neoplasms/radiotherapy/surgery/*therapy
Female
Humans
Male
Middle Aged
Neoplasm Staging
Survival Rate