Background We performed a multi-institutional randomized trial comparing preoperative chemotherapy followed by surgery with surgery alone for patients with local and operable esophageal cancer.
Methods Preoperative chemotherapy for patients randomly assigned to the chemotherapy group included three cycles of cisplatin and fluorouracil.
Surgery was performed two to four weeks after the completion of the third cycle ; patients also received two additional cycles of chemotherapy after the operation.
Patients randomly assigned to the immediate-surgery group underwent the same surgical procedure.
The main end point was overall survival.
Results Of the 440 eligible patients with adequate data, 213 were assigned to receive preoperative chemotherapy and 227 to undergo immediate surgery.
After a median possible study time of 55.4 months, there were no significant differences between the two groups in median survival : 14.9 months for the patients who received preoperative chemotherapy and 16.1 months for those who underwent immediate surgery (P=0.53).
At one year, the survival rate was 59 percent for those who received chemotherapy and 60 percent for those who had surgery alone ; at two years, survival was 35 percent and 37 percent, respectively.
The toxic effects of chemotherapy were tolerable, and the addition of chemotherapy did not appear to increase the morbidity or mortality associated with surgery. (...)
Mots-clés Pascal : Tumeur maligne, Oesophage, Localisé, Protocole thérapeutique, Traitement associé, Chimiothérapie, Chirurgie, Pronostic, Etude comparative, Randomisation, Adulte, Homme, Oesophage pathologie, Appareil digestif pathologie
Mots-clés Pascal anglais : Malignant tumor, Esophagus, Localized, Therapeutic protocol, Combined treatment, Chemotherapy, Surgery, Prognosis, Comparative study, Randomization, Adult, Human, Esophageal disease, Digestive diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0075685
Code Inist : 002B13A01. Création : 31/05/1999.