Esophageal Cancer Surgery Has Low Cure Rate

Prognosis of patients with esophageal cancer is generally poor after tumor surgery regardless of whether preoperative chemotherapy is used

MONDAY, Aug. 20 (HealthDay News) -- Short-term survival rates are poor for patients undergoing surgery or surgery with chemotherapy for esophageal cancer unless all resection tissue margins are disease-free, making the identification of new chemotherapeutic regimens a high priority, according to a report published in the Aug. 20 issue of the Journal of Clinical Oncology.

David P. Kelsen, M.D., of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues selected 467 localized esophageal cancer patients from the Radiation Therapy Oncology Group trial and treated 216 with chemotherapy followed by surgery and 227 with surgery alone to compare overall survival.

Researchers found the 59 percent of patients with surgery only and 63 percent with both chemo and surgery had R0 resections -- where all margins of resection were tumor free -- resulting in the best survival rate with 39 percent of patients being alive and disease-free at three years and 32 percent at five years. Prognosis was poor for other groups, about 12 percent survival over three years for R1 resection, and 4 percent for R2 or no resection. In addition, nine R1 patients who underwent post-surgery chemoradiotherapy survived.

"In summary, our study and retrospective reviews described herein indicate that outcome as measured by disease-free and overall survival strongly depends on performance of a complete resection including negative microscopical margins," the authors write. "The presence of even microscopic residual disease is a strong predictor of poor outcome."

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