Preoperative chemoradiation versus preoperative chemotherapy alone for esophageal cancer: Higher response rates but equivalent survival.

Abstract

4071 Background: Controversy exists over the optimal neoadjuvant therapy in patients with locally advanced esophageal cancer (EC). While most groups favor neoadjuvant chemoradiation (nCRT), some advocate preoperative chemotherapy (nCT) without radiation. The objective of this study was to compare outcomes in EC patients undergoing either regimen, followed by surgery. Methods: We reviewed a prospectively collected database of EC patients undergoing esophagectomy following nCT or nCRT (1989-2013). Choice of therapy was at the discretion of the multidisciplinary team. Demographic data, clinical and pathologic staging, and survival (KM) were compared. Results: From 600 patients, 261 patients were identified with EC treated with nCRT (n=63) or nCT (n=199) followed by surgery. Patients were well matched for age, gender, PS, histology, and clinical stage. Following therapy, more nCRT patients had a complete clinical response (36% vs. 14%, p<0.001) by post-induction endoscopy and CT/PET. At surgery, 88% and 92% o...