Long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma

John Lew, William E. Gooding, Ulysses Ribeiro, Adriana V. Safatle-Ribeiro, Mitchell C. Posner

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Hypothesis: Long-term survival is rare in patients treated for esophageal carcinoma. Several clinical trials suggest the possibility of prolonged survival in patients who undergo induction chemoradiotherapy plus esophagectomy. Design: Prospective uncontrolled study. Setting: University hospital. Patients and Methods: Forty-four patients with carcinoma of the esophagus or gastroesophageal junction were prospectively entered into a phase II trial of preoperative 5-fluorouracil, cisplatin, and interferon alfa with concurrent external beam radiotherapy before esophagectomy. Curative resection was performed on 36 of 41 patients who completed the induction chemoradiotherapy. Results: Of the 44 patients, 17 are alive at a median follow-up of 50 months. Of these 17 patients, 15 show no evidence of recurrent disease. Of the 14 patients with long-term survival (≥3 years), 1 patient died of disease, and another patient is alive with disease. The remaining 12 patients are alive and disease-free (median follow-up, 54 months). Six patients have survived longer than 4 years and 3 patients longer than 5 years. Subsequent primary tumors have developed in 2 patients. One patient had a recurrence at 11 months following initiation of treatment and remains disease-free 43 months postresection of a single brain metastasis. Standard clinicopathologic parameters (age, sex, histologic findings, chemoradiotherapy regimen, and clinical and pathologic stages) were not significantly associated with a survival time of 3 years or longer (Fisher exact test, 2-tailed). Although not significant, p53 mutational status suggested long-term survival. In 11 of 14 patients who are alive with no history of recurrence, p53 genotyping demonstrated no point mutations in 10 patients. Median survival time for the long-term survivors has not been reached. Conclusions: 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.

Original languageEnglish
Pages (from-to)737-742
Number of pages6
JournalArchives of Surgery
Volume136
Issue number7
StatePublished - Jul 24 2001
Externally publishedYes

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Esophagectomy
Chemoradiotherapy
Carcinoma
Survival
Recurrence
Esophagogastric Junction

ASJC Scopus subject areas

  • Surgery

Cite this

Lew, J., Gooding, W. E., Ribeiro, U., Safatle-Ribeiro, A. V., & Posner, M. C. (2001). Long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma. Archives of Surgery, 136(7), 737-742.

Long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma. / Lew, John; Gooding, William E.; Ribeiro, Ulysses; Safatle-Ribeiro, Adriana V.; Posner, Mitchell C.

In: Archives of Surgery, Vol. 136, No. 7, 24.07.2001, p. 737-742.

Research output: Contribution to journalArticle

Lew, J, Gooding, WE, Ribeiro, U, Safatle-Ribeiro, AV & Posner, MC 2001, 'Long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma', Archives of Surgery, vol. 136, no. 7, pp. 737-742.
Lew J, Gooding WE, Ribeiro U, Safatle-Ribeiro AV, Posner MC. Long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma. Archives of Surgery. 2001 Jul 24;136(7):737-742.
Lew, John ; Gooding, William E. ; Ribeiro, Ulysses ; Safatle-Ribeiro, Adriana V. ; Posner, Mitchell C. / Long-term survival following induction chemoradiotherapy and esophagectomy for esophageal carcinoma. In: Archives of Surgery. 2001 ; Vol. 136, No. 7. pp. 737-742.
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AU - Posner, Mitchell C.

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