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Ann Thorac Surg 1982;34:521-528
© 1982 The Society of Thoracic Surgeons

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Articles

Treatment of Esophageal Carcinoma by Combined Preoperative Chemotherapy

Thoracic Service, Department of Surgery, and the Solid Tumor Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY.

^* Address reprint requests to Dr. Bains, 1275 York Ave, New York, NY 10021.

Thirty-four patients with epidermoid carcinoma of the esophagus received a triple-drug regimen preoperatively consisting of cisplatin, vindesine, and bleomycin. Partial response to chemotherapy (greater than 50% reduction in measurable tumor size with concomitant improvement in swallowing function) was noted in 65% of the patients. Of the 34 patients, 28 (82%) had resectable disease. A one-stage high esophagogastrectomy utilizing the end-to-end anastomosis stapling device was performed on all 28 patients. Operation was followed by external radiation therapy to the esophageal bed, to a tumor dose of 5,500 rads delivered in 5 weeks. The postoperative median follow-up is now 14 months (range, 7 to 26 months). Thirteen patients are alive and well, and 10 patients have relapsed, 4 of whom are still alive with disease. Two patients died of postoperative complications, and 1 death was drug related. On the other hand, 5 of the 6 patients with unresected tumors died within 5 months. While the preliminary results are encouraging, longer follow-up will be required to determine whether the response rate to chemotherapy will result in a longer disease-free interval and longer survival.

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