Treatment of Carcinoma of the Esophagus and Gastric Cardia with Concentrated Preoperative Irradiation Followed by Early Operation

Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus

“…3,12,13,18 -22 However, the improved survival rate was not confirmed in randomized studies. [23][24][25][26][27][28][29][30][31][32] One randomized trial that compared preoperative chemotherapy with postoperative chemotherapy found in favor of preoperative chemotherapy. 33 However, randomized studies have not shown an advantage for preoperative chemotherapy over surgery alone in overall survival, DFS, or local control rates 34 -36 (2-year survival, 35% vs. 37% for surgery alone).…”

Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus

“…Some studies have claimed a survival advantage for patients who undergo preoperative radiotherapy alone with an improved resectability rate (82.1% vs. 39.7%) and an improved 5‐year survival rate (25% vs. 13.6%) 3, 12, 13, 18–22. However, the improved survival rate was not confirmed in randomized studies 23–32…”

Cancer of the oesophagus—how should tumour biology affect treatment?

“…This is in keeping with Pearson's observation ( 5 ) that signs of local recurrence after radiotherapy appear at about 1 year and also with the high local recurrence rate noted by Parker (8) after radiotherapy alone in localized disease. Furthermore, even in series which have not shown an improvement in survival after preoperative radiotherapy, comments have been made on improved local resectability (37,69). If combined intensive local therapy is to show benefit it should be in those patients without involved nodes.…”

“…Nakayama (3) reported on 3-year survival of 35.7 per cent in 14 node-negative patients with surgery alone whereas after preoperative radiotherapy all 7 similar patients survived 3 years. In recent series using preoperative radiotherapy the only long term survivors were patients without nodal metastases (37,38).…”