The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 6 , Pages 1309-1317 , December 2009

Recurrence after neoadjuvant chemoradiation and surgery for esophageal cancer: Does the pattern of recurrence differ for patients with complete response and those with partial or no response?

  • Robert A. Meguid, MD, MPH

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • R.A.M. and C.M.H. contributed equally to this article.
    • ,
  • Craig M. Hooker, MPH

      Affiliations

    • Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Md
    • R.A.M. and C.M.H. contributed equally to this article.
    • ,
  • Joshua T. Taylor, BS

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Laurence R. Kleinberg, MD

      Affiliations

    • Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Stephen M. Cattaneo II, MD

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Marc S. Sussman, MD

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Stephen C. Yang, MD

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Richard F. Heitmiller, MD

      Affiliations

    • Department of Thoracic Surgery, Union Memorial Hospital, Baltimore, Md
    • ,
  • Arlene A. Forastiere, MD

      Affiliations

    • Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Malcolm V. Brock, MD

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • Corresponding Author InformationAddress for reprints: Dr Malcolm V. Brock, Division of Thoracic Surgery, Department of Surgery, 600 North Wolfe St, Blalock 240, The Johns Hopkins Hospital, Baltimore, MD 21287.

Received 7 July 2008 ,Revised 26 June 2009 ,Accepted 29 July 2009.

References 

  1. Forastiere AA, Heitmiller RF, Kleinberg L. Multimodality therapy for esophageal cancer. Chest. 1997;112(4 Suppl):195S–200S
  2. Jackson C, Starling N, Chua YJ, Cunningham D. Pharmacotherapy for oesophagogastric cancer. Drugs. 2007;67:2539–2556
  3. Pennathur A, Luketich JD. Resection for esophageal cancer: strategies for optimal management. Ann Thorac Surg. 2008;85:S751–S756
  4. Reynolds JV, Muldoon C, Hollywood D, et al. Long-term outcomes following neoadjuvant chemoradiotherapy for esophageal cancer. Ann Surg. 2007;245:707–716
  5. Ancona E, Ruol A, Santi S, et al. Only pathologic complete response to neoadjuvant chemotherapy improves significantly the long term survival of patients with resectable esophageal squamous cell carcinoma: final report of a randomized, controlled trial of preoperative chemotherapy versus surgery alone. Cancer. 2001;91:2165–2174
  6. Chirieac LR, Swisher SG, Ajani JA, et al. Posttherapy pathologic stage predicts survival in patients with esophageal carcinoma receiving preoperative chemoradiation. Cancer. 2005;103:1347–1355
  7. Rohatgi P, Swisher SG, Correa AM, et al. Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response. Cancer. 2005;104:2365–2372
  8. Kleinberg L, Knisely JP, Heitmiller R, et al. Mature survival results with preoperative cisplatin, protracted infusion 5-fluorouracil, and 44-Gy radiotherapy for esophageal cancer. Int J Radiat Oncol Biol Phys. 2003;56:328–334
  9. Keats AS. The ASA classification of physical status—a recapitulation. Anesthesiology. 1978;49:233–236
  10. Heath EI, Burtness BA, Heitmiller RF, et al. Phase II evaluation of preoperative chemoradiation and postoperative adjuvant chemotherapy for squamous cell and adenocarcinoma of the esophagus. J Clin Oncol. 2000;18:868–876
  11. Greene FL, Fleming I, Fritz A, Balch C, Haller DG, eds. Esophagus. In: Cancer staging handbook. 6th ed. New York: Springer-Verlag; 2002.p.91-5.
  12. Rohatgi PR, Swisher SG, Correa AM, et al. Failure patterns correlate with the proportion of residual carcinoma after preoperative chemoradiotherapy for carcinoma of the esophagus. Cancer. 2005;104:1349–1355
  13. Urba SG, Orringer MB, Turrisi A, Iannettoni M, Forastiere A, Strawderman M. Randomized trial of preoperative cemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol. 2001;19:305–313
  14. Kleinberg L, Brock MV, Jagannath SB, Forastiere A. Cancer of the esophagus. 4th ed. Philadelphia: Churchill Livingstone Elsevier; 2008;
  15. Kelsen DP, Ginsberg R, Pajak TF, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med. 1998;339:1979–1984
  16. Takashima A, Shirao K, Hirashima Y, et al. Chemosensitivity of patients with recurrent esophageal cancer receiving perioperative chemotherapy. Dis Esophagus. 2008;

 Disclosures: R.A.M. was supported on the Ruth L. Kirschstein National Research Service Award (T32DK007713) while undertaking this study. M.V.B. was supported in part for this work by National Institutes of Health Award (NIH 1R33CA127055-01).

 Presented at the annual meeting of Western Thoracic Surgical Association, Kona, Hawaii, June 25, 2008.

PII: S0022-5223(09)01053-8

doi: 10.1016/j.jtcvs.2009.07.069

The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 6 , Pages 1309-1317 , December 2009

Article Tools

* Image Usage & Resolution