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1. Heise JW, Heep H, Frieling T, Sarbia M, Hartmann KA, Röher HD: Expense and benefit of neoadjuvant treatment in squamous cell carcinoma of the esophagus. BMC Cancer; 2001;1:20
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  • [Title] Expense and benefit of neoadjuvant treatment in squamous cell carcinoma of the esophagus.
  • BACKGROUND: The effectiveness of neoadjuvant treatment (NT) prior to resection of squamous cell carcinoma of the esophagus (SCCE) in terms of prolonged survival has not been proven by randomized trials.
  • Facing considerable financial expenses and with concerns regarding the consumption of the patient's remaining survival time, this study aims to provide rationales for pretreating resection candidates.
  • Since 1989, NT was offered to patients with mainly upper and middle third T3 or T4 tumors or T2 N1 stage who were fit for esophagectomy.
  • Until 1993, NT consisted of chemotherapy.
  • Since that time chemoradiation has also been applied.
  • The parameters for expense and benefit of NT are costs, pretreatment time required, postoperative morbidity and mortality, clinical and histopathological response, and actuarial survival.
  • Survival following NT + surgery was significantly prolonged in node-positive patients with a median survival of 12 months to 19 months (p = 0.0193).
  • The average pretreatment time was 113 +/- 43 days, and reimbursement for NT to the hospital amounted to Euro 9.834.
  • Expenses for pretreatment, particularly time and costs, are considerable.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Drug Therapy / economics. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / surgery. Neoadjuvant Therapy / economics
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / therapeutic use. Combined Modality Therapy. Cost-Benefit Analysis. Epirubicin / therapeutic use. Esophagectomy / methods. Female. Fluorouracil / therapeutic use. Humans. Leucovorin / therapeutic use. Male. Middle Aged. Neoplasm Staging / methods. Prospective Studies. Radiotherapy Dosage. Survival Analysis. Tomography, X-Ray Computed / methods

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  • (PMID = 11737874.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; FLEP protocol
  • [Other-IDs] NLM/ PMC61000
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2. Wu Z, Ma JY, Yang JJ, Zhao YF, Zhang SF: Primary small cell carcinoma of esophagus: report of 9 cases and review of literature. World J Gastroenterol; 2004 Dec 15;10(24):3680-2
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  • [Title] Primary small cell carcinoma of esophagus: report of 9 cases and review of literature.
  • AIM: To analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma (SCC) of the esophagus and to review the literature on this entity.
  • METHODS: The records of 9 patients with primary esophageal small cell carcinoma were examined and the demographic data, presenting symptoms, methods of tumor diagnosis, and types of treatment given, response to treatment, pathologic findings, and clinical outcome were reviewed.
  • In 5 cases the tumors were located in the mid-esophagus, 3 cases in the lower third of the esophagus and 1 case in the upper third.
  • The average length of esophageal involvement was 5 cm.
  • They underwent radical resection, regional lymph node clearance and esophageal-stomach anastomosis in thorax or at neck.
  • Two patients had a stage IIa disease, five had a stage IIb disease, and the other two had a stage III disease of International Union Contrele Cancer (UICC).
  • Three of the nine resected specimens showed foci of squamous cell carcinoma in situ.
  • They received adjuvant systemic chemotherapy and local radiation therapy after discharge.
  • During follow-up, three patients developed multiple liver, brain, lung and bone metastases and died between 5 and 18 mo after the diagnosis.
  • Three patients developed widespread metastasis disease and died between 18 and 37 mo after the diagnosis.
  • CONCLUSION: Primary small cell carcinoma of the esophagus is a rare but very malignant tumor.
  • Radical resection combined with chemotherapy and radiotherapy is helpful in limited stage cases.
  • [MeSH-major] Carcinoma, Small Cell / pathology. Esophageal Neoplasms / pathology
  • [MeSH-minor] Aged. Female. Humans. Male. Middle Aged. Neoplasm Staging

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  • (PMID = 15534932.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] China
  • [Number-of-references] 18
  • [Other-IDs] NLM/ PMC4612018
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3. Lyratzopoulos G, Barbiere JM, Gajperia C, Rhodes M, Greenberg DC, Wright KA: Trends and variation in the management of oesophagogastric cancer patients: a population-based survey. BMC Health Serv Res; 2009 Dec 15;9:231
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  • We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient subgroups.
  • METHODS: We analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma) during 1995-2006.
  • There was only limited information on stage, and no information on co-morbidity status.
  • During successive triennia, curative surgery use decreased from 28% to 20% (p < 0.001) whilst chemotherapy use increased from 9% to 30% (p < 0.001).
  • In multivariable logistic regression adjusting for age group, gender, diagnosis period and tumour type, curative surgery and chemotherapy were used less frequently in more deprived patients [per increasing deprivation group Odds Ratio (OR) = 0.96, 95% Confidence Interval (CI) 0.93-0.99, and OR = 0.90, 95%CI 0.87-0.93, respectively, p < 0.001 for both)].
  • Chemotherapy was also used less frequently in women (OR = 0.76, p < 0.001).
  • CONCLUSIONS: During the study period, curative surgery decreased by a third and chemotherapy use increased by more than three-fold, reflecting improvements in the appropriateness and quality of management, but chemotherapy use, in particular, was unequal, both by socioeconomic status and gender.

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  • (PMID = 20003488.001).
  • [ISSN] 1472-6963
  • [Journal-full-title] BMC health services research
  • [ISO-abbreviation] BMC Health Serv Res
  • [Language] ENG
  • [Grant] United Kingdom / Cancer Research UK / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Other-IDs] NLM/ PMC2813235
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4. Farzad M, De Luca MC, Rubino G, Pirtoli L, Pepi F, Sebaste L, Ponticelli P, Atzeni G, Maranzano E, Silvano G: [Effort to radically cure stage III and IV esophageal carcinoma with simultaneous radiotherapy and chemotherapy in standard clinical practice]. Radiol Med; 2001 Jul-Aug;102(1-2):72-7
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  • [Title] [Effort to radically cure stage III and IV esophageal carcinoma with simultaneous radiotherapy and chemotherapy in standard clinical practice].
  • [Transliterated title] L'intento di cura radicale del carcinoma esofageo al III e IV stadio con radioterapia e chemioterapia concomitanti nella pratica clinica comune.
  • PURPOSE: Chemotherapy and concurrent irradiation, intended to cure, are presently standard treatments for non metastatic, unresectable oesophageal cancer.
  • The results of the combined therapy are superior to those of radiotherapy alone, attaining 25-35% 2-year survival rates.
  • However these results mainly refer to stage I and II tumours as most of the available literature has focussed on these groups.
  • The aim of our report is to present our experience with Stage III and IV patients.
  • MATERIAL AND METHODS: Sixty-four Stage III and IV oesophageal cancer patients were referred to our Departments from January 1, 1990 to December 31, 1996.
  • Diagnosis was obtained through oesophagoscopy and biopsy, stage was assessed by physical examination, chest CT scan, bronchoscopy, barium X-ray examination, upper abdomen ultrasonography and bone nuclide scan.
  • The case features were as follows: histology of squamous cell carcinoma in 32 cases, of adenocarcinoma in 2; tumour in the upper third of the oesophagus in 11 (32.5%), in the middle third in 18 (53%), in the lower third in 5 (14.5%); male/female ratio 29/5, age 48-68 years (mean 56), Karnofsky performance status of 60% or higher.
  • Twenty-one had Stage III (61.75%) and 13 stage IV (38.25%) cancer, with metastasis limited to the supraclavicular or coeliac nodes, which could be included in the radiation volume.
  • In all cases chemotherapy consisted of 5-Fluoruracil (administered in a continuous i.v. infusion, from day 1 to 5, with a 750-1.000 mg/n.sq daily dose) and Cisplatin (75-100 mg/n.sq on the first day, or 20 mg/n.sq for 5 consecutive daily doses, administered by i.v. bolus).
  • Irradiation started with the first cycle of chemotherapy in 5 patients, with the second or third cycle in 29.
  • At least two cycles of chemotherapy were administered during the course of radiation.
  • Radiotherapy was performed with 4 to 18 MeV linear accelerator X-rays, or telecobalt, through opposite anterior and posterior treatment portals or more complex field arrangements.
  • The doses were in the range of 44-66 Gy, with fractionation of 5x180-200 cGy weekly sessions.
  • After treatment, periodic follow-up controls were carried out in all cases.
  • Data on improvement of swallowing were always available, however, and the early therapeutic results were analysed accordingly.
  • Two-year survival after conclusion of the treatment was calculated according to Kaplan and Maier.
  • Survival was analysed (log-rank test) according to stage, Performance Status, oesophagectomy and body weight loss.
  • RESULTS: After treatment, subjective symptomatic relief occurred in 17 of the 22 patients presenting dysphagia (77.5%).
  • Acute toxicity (Grade III or IV WHO) of the treatment accounted for 47% of hematologic adverse effects, 40% of mucositis, 20.5% of vomiting or diarrhoea not responding to drug treatment.
  • Treatment delays of more than one week, due to toxicity, occurred in 23.5%.
  • Overall 2 year survival was 13%, with a median value of 10 months.
  • Survival analysis, according to stage, showed 2 year values of 24% in Stage III and 0% in Stage IV (p=0.09).
  • Six patients showed a remarkable improvement in symptoms and general conditions after treatment, and were restaged with oesophagoscopy, thoracic CT scan and bronchoscopy, which evidenced resectable residual tumors, and they were then operated.
  • DISCUSSION AND CONCLUSIONS: Many Stage III and IV patients, selected for an aggressive chemo-radiation approach on the grounds of satisfactory medical conditions, can obtain relief of dysphagia.
  • Some cases, without extrathoracic spread of the tumor can achieve long term survival (in our experience 24% 2-year survival in Stage III, in our experience which favourably compares with the results obtained by other authors).
  • Whether surgery may improve the therapeutic results of chemo-radiotherapy in patients whose tumour has become resectable, is an issue that cannot be satisfactorily addressed on the basis of our experience, nor are the results from the available literature exhaustive to this regard.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging

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  • (PMID = 11677442.001).
  • [ISSN] 0033-8362
  • [Journal-full-title] La Radiologia medica
  • [ISO-abbreviation] Radiol Med
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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5. Osaka Y, Takagi Y, Tsuchida A, Hoshino S, Tachibana S, Shinohara M, Aoki T: Concurrent preoperative chemoradiotherapy for stage III or IV esophageal squamous carcinoma. Oncol Rep; 2004 Nov;12(5):1121-6
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  • [Title] Concurrent preoperative chemoradiotherapy for stage III or IV esophageal squamous carcinoma.
  • The poor progress of advanced esophageal carcinoma cannot be expected to be improved by surgical treatment alone.
  • We retrospectively examined the results of surgery alone (SA: 39 cases) and of concurrent preoperative chemoradiation therapy (PCRT: 51 cases) for stage III or IV esophageal squamous carcinoma.
  • In stage III, the 5-year survival rate was 58.6% for the PCRT group and 17.2% for the SA group (p=0.022).
  • In stage IV, the survival rate was 0% for the SA group and 16.7% for the PCRT group, showing better results in the latter, although there was no statistically significant difference.
  • Multivariate analysis of prognostic variables revealed that therapeutic method (presence or absence of PCRT) contributed the greatest to the prognosis.
  • These results indicate that PCRT is an effective adjuvant therapy for squamous cell carcinoma.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Female. Humans. Liver Diseases / etiology. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local / therapy. Neoplasm Staging. Postoperative Complications. Preoperative Care. Retrospective Studies. Survival Rate

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  • (PMID = 15492803.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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6. Zhang MY, Wang Z, Liu XY, Chen G, Liu FY: [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer]. Zhonghua Wai Ke Za Zhi; 2008 Jul 15;46(14):1048-50
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  • [Title] [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer].
  • OBJECTIVE: To investigate the local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage IIA middle-third thoracic esophageal cancer.
  • METHODS: From June 1999 to June 2002, 125 patients with stage IIA squamous cell carcinoma of the middle-third thoracic esophagus were treated with Ivor-Lewis esophagectomy with two-fields lymphadenectomy.
  • Of all cases of recurrence, 38 patients (30.4%) developed locoregional recurrence (including 5 patients with locoregional and hematogenous recurrence simultaneously).
  • The locoregional recurrence rate of patients who received postoperative radiotherapy (20.3%) was significantly lower than that of both the group who received adjunctive chemotherapy (40.6%) and the group without adjunctive therapy (41.4%) (P < 0.05).
  • Radiotherapy following Ivor-Lewis esophagectomy is an effective strategy to control local recurrence of the stage II A middle-third thoracic esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Radiotherapy, Adjuvant
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging. Retrospective Studies. Survival Analysis

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  • (PMID = 19094527.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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7. Tran Vuong TN, Le Prisé E, Vauléon E, Boucher E, Audrain O, Raoul JL: Chemoradiotherapy for cancer of the esophagus: contribution of the leucovorin, 5-fluorouracil bolus, and infusion-cisplatin-radiotherapy schedule starting with two neoadjuvant chemotherapy cycles: results from a pilot study. Dis Esophagus; 2010 May;23(4):324-8
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  • [Title] Chemoradiotherapy for cancer of the esophagus: contribution of the leucovorin, 5-fluorouracil bolus, and infusion-cisplatin-radiotherapy schedule starting with two neoadjuvant chemotherapy cycles: results from a pilot study.
  • To assess feasibility and tolerance of a modification in the usual radiochemotherapy regimen for esophageal cancer by using a leucovorin, 5-fluorouracil bolus, and infusion-cisplatin regimen (six cycles), beginning with two cycles of chemotherapy before conventional radiotherapy (50 Gy), 33 patients, 30 were men, 62.8 +/- 9.5 years, were treated for an esophageal carcinoma (29 squamous cell), 27 of these were in stage III (based on computed tomography scan).
  • Neoadjuvant chemotherapy was well tolerated; concomitant radiochemotherapy was associated with severe adverse events mostly hematological in 23 patients.
  • More than one-third of cycles could be performed as outpatients.

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  • (PMID = 19863643.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 12001-76-2 / Vitamin B Complex; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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8. Díaz R, Reynes G, Tormo A, de Juan M, Gironés R, Segura A, Aparicio J, Richart P, de la Cueva H, García J: Long-term results of neoadjuvant chemotherapy and combined chemoradiotherapy before surgery in the management of locally advanced oesophageal cancer: a single-centre experience. Clin Transl Oncol; 2009 Dec;11(12):835-41
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  • [Title] Long-term results of neoadjuvant chemotherapy and combined chemoradiotherapy before surgery in the management of locally advanced oesophageal cancer: a single-centre experience.
  • INTRODUCTION: Neoadjuvant chemoradiotherapy before surgery is an option in the treatment of locally advanced resectable oesophageal cancer (EC).
  • METHODS: This was a prospective, single-centre study of neoadjuvant chemotherapy and concomitant chemoradiotherapy with CDDP and 5-FU and 50.4 Gy of external radiotherapy before possible radical surgery in patients with locally advanced resectable EC.
  • If surgery was not possible, a second-phase radiotherapy boost of 10 Gy and one cycle of modified dose chemotherapy were used.
  • RESULTS: Seventy-three patients included between 1998 and 2007: 96% males, median age 61, 83% squamous cell carcinomas, 23% lower third tumours, 36% stage II and 54% stage III and 47% local lymph node involvement.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophageal Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Algorithms. Combined Modality Therapy. Disease Progression. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoadjuvant Therapy. Survival Analysis. Time Factors

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  • (PMID = 20045790.001).
  • [ISSN] 1699-3055
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Italy
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9. Adham M, Baulieux J, Mornex F, de La Roche de Bransat E, Ducerf C, Souquet JC, Gerard JP: Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus. Cancer; 2000 Sep 1;89(5):946-54
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  • [Title] Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus.
  • BACKGROUND: Surgery remains the treatment of choice for patients with esophageal squamous cell carcinoma (SCC), but survival rates have not improved over the past decades.
  • The objective of this study was to evaluate the effect of multimodal therapy on resectability, on the overall and on disease free survival (DFS) rates, and on the laryngeal resection rate.
  • METHODS: Fifty-five patients (49 men and 6 women) with a mean age of 58 +/- 8 years underwent combined modality treatment for esophageal SCC.
  • The tumor location was in the upper one-third of the esophagus in 19 patients, the middle one-third in 22 patients, the lower one-third in 9 patients, and the upper and lower one-thirds in 5 patients.
  • The intent of combined therapy was curative in 87.3% of patients and palliative in 12.7% of patients.
  • Neoadjuvant treatment consisted of two courses of 5-fluorouracil and cisplatin on Days 1-5 and Days 21-25.
  • RESULTS: Full neoadjuvant treatment was possible in 67.3% of patients and was uneventful in 56.
  • The tumor stages according to the American Joint Committee on Cancer staging system were pT0N0 in 12 patients, Stage 0 in 8 patients, Stage IIa in 6 patients, Stage IIb in 6 patients, Stage III in 8 patients, and Stage IV in 13 patients.
  • CONCLUSIONS: Neoadjuvant treatment is tolerated well by most patients.
  • Combination therapy increases the resectability rate and facilitates laryngeal preservation.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Larynx / surgery. Male. Middle Aged. Neoplasm Staging. Postoperative Complications. Survival Rate. Treatment Outcome


10. Mariette C, Taillier G, Van Seuningen I, Triboulet JP: Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma. Ann Thorac Surg; 2004 Oct;78(4):1177-83
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  • [Title] Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma.
  • BACKGROUND: To identify factors affecting postoperative course and survival after esophagectomy for cancer and reasons for improved survival over time.
  • METHODS: Complete esophageal resection was attempted for middle and lower third esophageal carcinomas in 386 consecutive patients between January 1982 and January 2002.
  • Five-year survival rate after R0 resection increased from 29% to 46% (p = 0.001), with a decreased recurrence rate from 65.8% to 44.3% (p = 0.002).
  • Three favorable prognostic factors were identified: low pT stage, pN0 stage, and operation during the 1994 to 2002 study period.
  • CONCLUSIONS: Short-term outcome and survival of patients with resected esophageal cancer have improved over time.
  • [MeSH-major] Adenocarcinoma / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cohort Studies. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Hospital Mortality. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Postoperative Complications / epidemiology. Preoperative Care. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Risk Factors. Survival Analysis. Survival Rate. Tomography, X-Ray Computed

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  • (PMID = 15464466.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 21
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11. Button MR, Morgan CA, Croydon ES, Roberts SA, Crosby TD: Study to determine adequate margins in radiotherapy planning for esophageal carcinoma by detailing patterns of recurrence after definitive chemoradiotherapy. Int J Radiat Oncol Biol Phys; 2009 Mar 1;73(3):818-23
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  • [Title] Study to determine adequate margins in radiotherapy planning for esophageal carcinoma by detailing patterns of recurrence after definitive chemoradiotherapy.
  • PURPOSE: To ascertain the adequacy of radiotherapy (RT) margins by studying the relapse patterns after definitive chemoradiotherapy for carcinoma of the esophagus.
  • METHODS AND MATERIALS: We performed a retrospective study assessing the first site of disease relapse after definitive chemoradiotherapy that included four 3-weekly cycles of cisplatin and continuous infusion 5-fluorouracil, with conformal RT (50 Gy in 25 fractions) concurrent with Cycles 3 and 4.
  • The RT planning target volume was the endoscopic ultrasonography/computed tomography-defined gross tumor volume with 1.5-cm lateral and 3-cm superoinferior margins.
  • Their average age was 65.4 years, 45% had adenocarcinoma, 61% had lower third esophageal tumors, and 75% had Stage III-IVA disease.
  • The local relapse rates were not influenced by tumor stage, lymph node status, or disease length.
  • Three patients developed a relapse in regions adjacent to the RT fields; however, it is unlikely that larger field margins would have been clinically acceptable or effective in these cases.
  • Future efforts to improve outcomes using definitive chemoradiotherapy should be directed toward reducing the high rates of in-field and distant relapses.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Neoplasm Recurrence, Local
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Adult. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / secondary. Cisplatin / administration & dosage. Combined Modality Therapy / methods. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Radiotherapy Dosage. Radiotherapy Planning, Computer-Assisted. Retrospective Studies. Tumor Burden

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1623; author reply 1623 [19931740.001]
  • (PMID = 18718726.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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12. Vandenbroucke F, Lozac'h P, Metges JP, Malhaire JP: [Results of surgical resection of squamous cells carcinoma of the oesophagus with or without preoperative radiochemotherapy: comparative and retrospective study]. Ann Chir; 2004 Dec;129(10):583-8
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  • [Title] [Results of surgical resection of squamous cells carcinoma of the oesophagus with or without preoperative radiochemotherapy: comparative and retrospective study].
  • [Transliterated title] Résultats de la radiochimiothérapie préopératoire dans les cancers épidermoïdes de l'oesophage: étude rétrospective et comparative.
  • AIM OF THE STUDY: The aim of the study was to assess preoperative radio-chemotherapy for squamous cell carcinoma of the esophagus.
  • MATERIAL AND METHODS: This study was a retrospective comparison between radio-chemotherapy followed by surgical resection (RCPO) and surgery alone.
  • The RCPO group included patients with tumor located in the middle or lower third of the esophagus, staged T2 or T3 tumors without distant metastases by pretherapeutic assessment.
  • Both groups were matched for gender, age, tumor localization (middle or lower third), T stage, and surgical procedure.
  • Each group included 77 men and 9 women, 50 tumors of the middle third and 36 of the lower third of the oesophagus, and 19 tumors T2 and 67 T3 ones.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Morbidity. Postoperative Complications. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 15581819.001).
  • [ISSN] 0003-3944
  • [Journal-full-title] Annales de chirurgie
  • [ISO-abbreviation] Ann Chir
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
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13. Anderson SE, O'Reilly EM, Kelsen DP, Ilson DH: Phase II trial of 96-hour paclitaxel in previously treated patients with advanced esophageal cancer. Cancer Invest; 2003;21(4):512-6
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  • [Title] Phase II trial of 96-hour paclitaxel in previously treated patients with advanced esophageal cancer.
  • Given the activity of paclitaxel in esophageal cancer, a phase II trial of 96-hour infusion paclitaxel in esophageal cancer was undertaken.
  • METHODS: Both adenocarcinoma and squamous cell histology were included.
  • Patients who had metastatic disease to the liver and transaminases greater than two times normal value received 120 mg/m2.
  • Response to treatment was evaluated after the first two cycles and subsequently every third cycle.
  • All were eligible for response and had stage IV disease.
  • All 13 received prior short-duration paclitaxel-containing chemotherapy regimens.
  • Eleven patients had adenocarcinoma and three squamous cell cancer.
  • Ninety-six-hour paclitaxel in metastatic esophageal cancer is generally well tolerated with minimal toxicity; however, it is ineffective in previously treated patients.
  • Further evaluation of this schedule of paclitaxel in combination with concurrent radiotherapy, where its radiosensitizing potential may be useful, is ongoing in locally advanced esophageal cancer.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / pharmacology. Carcinoma, Squamous Cell / drug therapy. Esophageal Neoplasms / drug therapy. Paclitaxel / administration & dosage. Paclitaxel / pharmacology
  • [MeSH-minor] Adult. Aged. Disease Progression. Female. Humans. Infusions, Intravenous. Male. Middle Aged. Treatment Outcome

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  • (PMID = 14533440.001).
  • [ISSN] 0735-7907
  • [Journal-full-title] Cancer investigation
  • [ISO-abbreviation] Cancer Invest.
  • [Language] eng
  • [Grant] United States / PHS HHS / / UO166913
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel
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14. Kenjo M, Uno T, Murakami Y, Nagata Y, Oguchi M, Saito S, Numasaki H, Teshima T, Mitsumori M: Radiation therapy for esophageal cancer in Japan: results of the Patterns of Care Study 1999-2001. Int J Radiat Oncol Biol Phys; 2009 Oct 1;75(2):357-63
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  • [Title] Radiation therapy for esophageal cancer in Japan: results of the Patterns of Care Study 1999-2001.
  • PURPOSE: To describe patient characteristics and the process of radiotherapy (RT) for patients with esophageal cancer treated between 1999 and 2001 in Japan.
  • METHODS AND MATERIALS: The Japanese Patterns of Care Study (PCS) Working Group conducted a third nationwide survey of 76 institutions.
  • Detailed information was accumulated on 621 patients with thoracic esophageal cancer who received RT.
  • Ninety-nine percent had squamous cell carcinoma histology.
  • Fifty-five percent had the main lesion in the middle thoracic esophagus.
  • Fourteen percent had clinical Stage 0-I disease, 32% had Stage IIA-IIB, 43% had Stage III, and 10% had Stage IV disease.
  • Chemotherapy was given to 63% of patients; 39% received definitive chemoradiotherapy (CRT) without surgery and 24% pre- or postoperative CRT.
  • Median total dose of external RT was 60 Gy for definitive CRT patients, 60 Gy for RT alone, and 40 Gy for preoperative CRT.
  • CONCLUSIONS: This PCS describes general aspects of RT for esophageal cancer in Japan.
  • Squamous cell carcinoma accounted for the majority of patients.
  • The standard total external RT dose for esophageal cancer was higher in Japan than in the United States.
  • Chemoradiotherapy had become common for esophageal cancer treatment, but patients aged > or =75 years were more likely to be treated by RT only.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / radiotherapy. Health Care Surveys
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Aged. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / radiotherapy. Carcinoma, Adenosquamous / surgery. Combined Modality Therapy / methods. Combined Modality Therapy / utilization. Female. Humans. Japan. Male. Middle Aged. Neoplasm Staging. Radiotherapy / methods

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  • (PMID = 19735863.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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15. Denham JW, Steigler A, Kilmurray J, Wratten C, Burmeister B, Lamb DS, Joseph D, Delaney G, Christie D, Jamieson G, Smithers BM, Ackland S, Walpole E: Relapse patterns after chemo-radiation for carcinoma of the oesophagus. Clin Oncol (R Coll Radiol); 2003 May;15(3):98-108
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  • [Title] Relapse patterns after chemo-radiation for carcinoma of the oesophagus.
  • AIM: The detailed review of patterns of failure in this report was undertaken to identify the continuing obstacles to the successful management of oesophageal cancer, and to establish whether there is a case to compare definitive chemo-radiation (Def-CR) and surgery for patients with squamous cancer in a randomized controlled trial.
  • MATERIALS AND METHODS: First and subsequent sites of failure were reviewed in 274 patients treated with Def-CR using two cycles of cisplatin, infusional fluorouracil and 60 Gy; and 92 patients with limited chemo-radiation (CR), using one cycle and 35 Gy, followed by surgery (CR-Surg).
  • Failure patterns were analysed using competing risks methodology, and pre-treatment variables predicting survival were identified by proportional hazards modelling.
  • RESULTS: Site, stage, performance status and gender were independently predictive of survival following Def-CR.
  • Lowest rates of local and distant failure at 5 years (29.9% and 26%) occurred in patients with squamous cancer (SCC) located in the upper-third, whose 5-year survival was also the most favourable (49.2%).
  • Outcomes were least favourable in patients with AC of the lower-third in whom 57.7% failed distantly and 5-year survival was 3.8%.
  • CONCLUSION: The concurrent administration of chemotherapy with radiotherapy seems to have improved loco-regional control and has exposed distant failure as an obstacle to further improvements in outcome.
  • Site, histological subtype, gender and response to chemo-radiation may predict biological differences in oesophageal cancer (OC) that influence outcome.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Neoplasm Recurrence, Local
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Male. Middle Aged. Prognosis. Randomized Controlled Trials as Topic. Retrospective Studies. Survival Analysis

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  • (PMID = 12801045.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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16. Palanivelu C, Prakash A, Senthilkumar R, Senthilnathan P, Parthasarathi R, Rajan PS, Venkatachlam S: Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position--experience of 130 patients. J Am Coll Surg; 2006 Jul;203(1):7-16
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  • Most series report thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in the left lateral position with respiratory complications up to 8% and prolonged operative time, probably because of inadequate stance of the surgeon during the thoracoscopic part.
  • This study shows the potential of the thoracoscopic part of the procedure in prone position to ease these difficulties.
  • All patients had histologically proved squamous cell carcinoma of the middle third of the esophagus.
  • Only one (0.77%) patient received neoadjuvant chemotherapy.
  • The thoracoscopic part of the procedure was performed in prone position with excellent ergonomics, translating into less operative time and better respiratory results.
  • At mean followup of 20 months (range 2 to 70 months), stage-specific survival was similar to open and other minimally invasive series.
  • CONCLUSIONS: TLE with thoracoscopic part in prone position is technically feasible, with a low incidence of respiratory complications and less operative time required.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Lymph Node Excision / methods. Thoracoscopy
  • [MeSH-minor] Adult. Aged. Cohort Studies. Female. Humans. Male. Mediastinum. Middle Aged. Prone Position. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 16798482.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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17. Francioni F, Anile M, Venuta F, De Giacomo T, Andreetti C, Diso D, Di Stasio M, D'Ecclesia G, Liparulo V, Coloni GF: [Mechanical cervical esophagogastric anastomosis after esophagectomy for cancer]. Minerva Chir; 2006 Apr;61(2):79-83
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  • AIM: Fibrous stenosis of the esophagogastric cervical anastomosis remains a significant complication occurring in up to one third of cases.
  • Trying to reduce the incidence of this complication, we describe our technique of cervical esophago-gastric anastomosis using endoscopic linear stapler which seems to reduce the incidence of fibrous stricture formation after resection of esophageal cancer.
  • Eight patients with advanced stage (5 T3 and 3 T4) underwent induction chemotherapy.
  • The most of patients was affected by squamous cell carcinoma.
  • Anastomotic leak developed in 1 case.
  • No patient developed fibrous stenosis that required dilatation therapy.
  • CONCLUSIONS: Complete mechanical esophago-gastric anastomosis, using endoscopic linear stapler is effective and safe, even when a narrow gastric tube is used as esophageal substitute.
  • [MeSH-major] Esophageal Neoplasms / surgery. Esophagectomy / adverse effects. Esophagus / surgery
  • [MeSH-minor] Adult. Aged. Anastomosis, Surgical. Constriction, Pathologic / etiology. Constriction, Pathologic / surgery. Female. Humans. Male. Middle Aged. Suture Techniques

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  • (PMID = 16871138.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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