Curative Treatment for Esophageal Cancer: Vancouver Island Cancer Centre Experience from 1993 to 1998

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dc.contributor.author Wilson, Kenneth S.
dc.contributor.author Wilson, Amanda G.
dc.contributor.author Dewar, Gary J.
dc.date.accessioned 2017-11-01T13:21:21Z
dc.date.available 2017-11-01T13:21:21Z
dc.date.copyright 2002 en_US
dc.date.issued 2002
dc.identifier.citation Wilson, K.S., Wilson, A.G. & Dewar, G.J. (2002). Curative Treatment for Esophageal Cancer: Vancouver Island Cancer Centre Experience from 1993 to 1998. Canadian Journal of Gastroenterology, (16)6, 361-368. http://dx.doi.org/10.1155/2002/767602 en_US
dc.identifier.uri http://dx.doi.org/10.1155/2002/767602
dc.identifier.uri http://hdl.handle.net/1828/8766
dc.description.abstract OBJECTIVES: To review outcomes after curative treatment for esophageal cancer in the Vancouver Island Cancer Centre from 1993 to 1998. Curative treatments included esophagectomy alone, and chemoradiotherapy with ‘selective surgery’ for patients with post-treatment-positive endoscopic biopsy or less than 75% regression on computed axial tomography scan, or with resectable local recurrence. METHODS: Patients undergoing esophagectomy alone, or primary chemoradiotherapy and ‘selective surgery’ were reviewed. This was a retrospective, nonrandomized, institutional experience. Surgical complication, relief of dysphagia, disease-specific survival rates and prognostic factors were analyzed. RESULTS: Nineteen patients underwent esophagectomy alone. A total of 56 patients underwent primary chemoradiotherapy, of whom 16 had ‘selective surgery’. Relief of dysphagia was similar in both groups of esophagectomy patients. Exploration for ‘selective surgery’ was performed in 12 patients after their first postchemo-radiotherapy endoscopy (two patients had unresectable disease), and in seven for relapse, one of whom died intraoperatively. Overall, the mortality rate due to surgery was 3%. Chemoradiotherapy was not associated with more frequent serious surgical complications. For patients who underwent esophagectomy alone and those who underwent chemoradiotherapy plus selective surgery, the median survival times were 12.9 and 16.4 months, respectively, and the three-year survival rates were 21% and 37%, respectively. Seventeen of 25 patients who underwent chemoradiotherapy and who survived more than two years have not required selective surgery. For the two groups of patients combined, no single prognostic factor for survival was significant in multivariate analysis, but for patients who underwent chemoradiotherapy plus selective surgery, negative endoscopic biopsy was highly significant. CONCLUSIONS: Surgical complication and disease-specific survival rates after primary chemoradiotherapy with selective surgery compare favourably with esophagectomy alone in the curative treatment of esophageal cancer. A prospective, randomized trial is necessary for the definitive evaluation of the strategy of chemoradiotherapy and selective surgery. en_US
dc.description.sponsorship This article was published in abstract form at the Annual Meeting of the American Society of Clinical Oncology, New Orleans, May 19 to 23, 2000. en_US
dc.language.iso en en_US
dc.publisher Canadian Journal of Gastroenterology en_US
dc.rights Attribution-NonCommercial 2.5 Canada *
dc.rights.uri http://creativecommons.org/licenses/by-nc/2.5/ca/ *
dc.title Curative Treatment for Esophageal Cancer: Vancouver Island Cancer Centre Experience from 1993 to 1998 en_US
dc.type Article en_US
dc.description.scholarlevel Faculty en_US
dc.description.reviewstatus Reviewed en_US

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