Combined modality treatment of stage II-III esophageal cancer: a single center experience

U B Urmonov,A S Tarasova,M Yu Volkov,S G Afanasyev,A V Avgustinovich,A Yu Dobrodeev,D N Kostromitsky

doi:10.31146/1682-8658-ecg-191-7-48-55

Abstract

The purpose of the study was to analyze efficacy and tolerability of combined modality treatment including preoperative chemotherapy with gemcitabine/cisplatin in patients with stage II-III esophageal squamous cell carcinoma. Materials and methods. The study included 70 patients with stage II-III esophageal squamous cell carcinoma. All patients were divided into two groups. Group I (study group) consisted of 35 patients, who received 2 courses of preoperative chemotherapy followed by radical surgery. Group II (control group) comprised 35 patients who underwent surgery alone. The 2-year survival rates were analyzed. Results. Combined modality treatment including preoperative chemotherapy with gemcitabine/cisplatin was well tolerated. The 2-year disease-free survival rates were 71.8% and 39.4% in groups I and II, respectively (р<0.05). The overall 2-year survival rate was 81.3% in patients who received chemotherapy followed by surgery and 51.5% in patients who underwent surgery alone (р<0.05). Conclusion. Compared to surgery alone, combined modality treatment including preoperative chemotherapy with gemcitabine/cisplatin significantly reduced the frequency of local recurrence and distant metastases and increased 2-year survival rate in patients with stage II-III esophageal squamous cell carcinoma, including the presence of unfavorable prognostic factors, such as regional lymph node metastases (N+) and high-grade (G3) squamous cell carcinoma.

Highlights

Compared to surgery alone, combined modality treatment including preoperative chemotherapy with gemcitabine/cisplatin significantly reduced the frequency of local recurrence and distant metastases and increased 2-year survival rate in patients with stage II–III esophageal squamous cell carcinoma, including the presence of unfavorable prognostic factors, such as regional lymph node metastases (N+) and high-grade (G3) squamous cell carcinoma
При дисфагии III–IV степени в основной группе у 16 (45,7%) и в контрольной группе у 14 (40%) больных проводилось парентеральное питание, состав и объем которого зависел от состояния больного и лабораторных показателей
Из нежелательных явлений предоперационной ХТ по схеме гемцитабин/цисплатин наиболее часто встречалась тошнота/рвота (27,1%), далее следовала гематологическая токсичность, включая лейкопению (20%), в том числе I–II (15,7%) и III–IV степени (4,3%), и тромбоцитопению (18,6%), в том числе I–II (12,8%) и III (5,7%) степени

Summary

Materials and methods

The study included 70 patients with stage II–III esophageal squamous cell carcinoma. All patients were divided into two groups. Group I (study group) consisted of 35 patients, who received 2 courses of preoperative chemotherapy followed by radical surgery. Group II (control group) comprised 35 patients who underwent surgery alone.

Results

Conclusion

Материалы и методы

Желудочная стебель Толстая кишка

Кумулятивная выживаемость