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Ann Thorac Surg 1994;57:1126-1132
© 1994 The Society of Thoracic Surgeons

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Articles

Induction therapy for squamous carcinoma of thoracic esophagus

¹ First Department of General Surgery, University of Verona, Department of Clinical Oncology, Ospedale Maggiore Verona, Italy
² Department of Surgery, University of Chicago, Chicago, Illinois, USA

Accepted for publication July 16, 1993.

^_* Address reprint requests to Dr Laterza, First Department of General Surgery, University of Verona—Ospedale Maggiore, P.le Stefari, 1 Verona, 37126 Italy.

From June 1987 to March 1992, 70 patients with squamous cell carcinoma of the esophagus were entered into a treatment protocol that included a preoperative course of radiotherapy (3,000 cGy) and chemotherapy (cisplatin and 5-fluoruracil). The preoperative therapy was well tolerated. Forty-nine of these patients underwent esophageal resection (total or subtotal) and 6 patients died subsequently (12.2%). The morbidity was not dramatically affected by preoperative treatment. Histopathologic studies showed no residual disease in the resected specimen of 11 patients (19.2%), only some residual microscopic clusters of neoplastic cells in 8 patients (14%) and macroscopic cancer in the remaining patients (66.8%). The estimated overall Kaplan-Meier survival at 1,2, and 3 years was 53.6%, 28.6%, and 21.5%, respectively. Our study, like other reports, demonstrates an improved survival in the group of patients who had a complete response after radiotherapy or chemotherapy (p = 0.002). Moreover, the lack of diagnostic procedures to evaluate the presence of residual tumor after radiotherapy and chemotherapy, suggests that only surgical resection can provide an accurate prognostic information and a complete treatment.

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