Treatment of @entity418 has traditionally included surgery as the initial modality. Neoadjuvant chemoradiation therapy has been introduced with the goal of downstaging @entity5 before surgical resection; however, its role in @entity418 remains controversial. We report 116 @entity1 who underwent esophagogastrectomy with reconstruction for @entity189 or esophagogastric junction over a 10-year period (January 1, 1990 to June 1, 2001). Forty @entity1 underwent neoadjuvant radiation and chemotherapy followed by surgery. Hospital mortality in this group was 7.5 per cent, complete pathologic response (CPR) was 37.5 per cent, and overall 3- and 5-year survival rates were 47 and 38 per cent. Five-year survival in the 15 @entity1 with CPR was 85 per cent. Five @entity1 underwent neoadjuvant single-agent therapy (four chemotherapy and one radiation) followed by surgery, and none survived to 3 years. Seventy-one @entity1 underwent surgery without neoadjuvant therapy. Hospital mortality in this group was 1.4 per cent, with 3- and 5-year survival of 21 and 17 per cent--a decreased long-term survival compared with the neoadjuvant therapy group despite the observation that @entity1 who underwent neoadjuvant therapy had a larger @entity5 size on presentation (5.5 +/- 0.4 cm vs 3.8 +/- 0.2 cm; P = 0.002). @entity957 seemed to be more responsive to neoadjuvant radiation and chemotherapy followed by surgery than were @entity420 , with a CPR of 44.4 versus 35.5 per cent; however, 5-year survival rates in these complete responders were not significantly different (100% and 78%, respectively; P = 0.97). We report that esophagogastrectomy in conjunction with neoadjuvant therapy results in increased survival compared with surgery without neoadjuvant therapy (P < 0.01), although there may be an increased perioperative mortality associated with neoadjuvant therapy. Further studies are needed to evaluate the role of preoperative chemoradiation and to better identify the pretreatment characteristics of @entity1 with a complete pathological response.

Multimodality treatment for XXXX : the role of surgery and neoadjuvant therapy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity957 :: ('MESH:D002294', 'Disease') :: ['Squamous cell carcinomas'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma of the esophagus'] @entity418 :: ('MESH:D004938', 'Disease') :: ['esophageal cancer'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinomas']
@entity418 :: (MESH:D004938,Disease) :: ['esophageal cancer']
