An article recently published in the Journal of Clinical Oncology reveals that a positive response to combined treatment with chemotherapy and radiation followed by surgery is associated with improved survival in patients with esophageal cancer.
The esophagus is a hollow tube that connects the throat and stomach, allowing transportation of food and fluids. The tube is made up of several layers of tissues, muscle and connective tissues. Esophageal cancer is a malignancy of the esophagus, which begins at the innermost lining of the esophagus and grows outward through the other layers. The prognosis for esophageal cancer depends on these three factors: the stage of the disease at which it is diagnosed, the size of the tumor and the patient’s general health. Current treatment options include surgery, radiation, chemotherapy or a combination of these options. In an attempt to improve the survival of patients with esophageal cancer, previous research has focused on initially treating the patient with a combination chemotherapy and radiation (CRT) given concurrently, followed by surgical removal of any residual tumor.
In this recent study, researchers evaluated which treatment-related variables could help predict survival and recurrence. The 171 patients diagnosed with invasive esophageal cancer and enrolled in the study included primarily men (85 percent) and the average age of study participants was sixty years. Of the 171, the majority (131 or 77 percent) underwent preoperative combined chemotherapy and radiation. Various surgical techniques were employed with a 5 percent rate of death during surgery. Overall survival time of the entire group was 33 months, with 26 percent of participants alive at five years. Initial treatment with CRT improved survival rate over surgery alone: a 33-percent 5-year survival rate versus only 11 percent. Additionally, patients who were considered to have a lesser stage of disease after surgery also had improved overall survival rates and disease-free survival rates when compared to patients whose stage was unchanged after surgery. The complete surgical removal of the tumor was also a significant factor in determining overall survival rates and disease-free survival rates.
Researchers concluded that the patient’s response to CRT and the ability to completely remove the tumor surgically were significantly associated with improved overall survival.
Reference: Berger A, Farma J, Scott W, et al.Complete Response to Neoadjuvent Chemoradiotherapy in Esophageal Carcinoma is Associated with Significantly Improved Survival. Journal of Clinical Oncology.2005; 23: 4330-4337.