The researchers investigated the long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma.
They reported their findings in the July issue of Archives of Surgery.
44 patients with carcinoma of the esophagus or gastroesophageal junction were prospectively entered into the Phase II trial.
Preoperative 5-fluorouracil, cisplatin, and interferon alfa was administered, with concurrent external beam radiotherapy, before esophagectomy.
Curative resection was performed on 36 of 41 patients who completed the induction chemoradiotherapy.
Of the 44 patients, 17 were alive at a median follow-up of 50 months. Of these 17 patients, 15 show no evidence of recurrent disease.
14 patients survived over 3 years. Of these, 1 patient died of disease, and another patient is currently alive with disease. The remaining 12 patients are alive and disease-free (median follow-up, 54 months).
|Recurrence unlikely in patients who survive over 3 years.|
|Archives of Surgery|
6 patients have survived longer than 4 years, and 3 patients longer than 5 years.
Subsequent primary tumors developed in 2 patients.
One patient had a recurrence at 11 months, following initiation of treatment, and remains disease-free 43 months post-resection of a single brain metastasis.
Standard clinicopathologic parameters (age, sex, histologic findings, chemoradiotherapy regimen, and clinical and pathologic stages) were not found to be significantly associated with a survival time of 3 years or longer.
The researchers found that, although not significant, p53 mutational status suggested long-term survival.
In 11 of 14 patients who were alive with no history of recurrence, p53 genotyping demonstrated no point mutations in 10 patients.
John I. Lew, of the University of Chicago Hospitals and the Pritzker School of Medicine, USA, concluded on behalf of the group, "Long-term survival can be achieved in patients with esophageal carcinoma who undergo induction chemoradiotherapy and esophagectomy.
"Recurrence is unlikely in patients who survive for 3 years or longer after undergoing this multimodality treatment."