PURPOSE: The diagnosis of @entity418 has historically been associated with a poor prognosis. Recently, investigators have reported improved outcomes for this @entity1 population with the use of trimodality therapy. These results have fueled the debate regarding which @entity1 may benefit from this aggressive treatment course. This retrospective analysis was conducted in order to evaluate the importance of regional lymph node involvement, determined by surgical staging before the initiation of therapy. @entity1 AND MATERIALS: Between July 1991 and June 1999, 45 @entity1 underwent surgical staging with thoracoscopy and/or laparoscopy followed by induction chemoradiation and surgical resection. All @entity1 underwent consultation in our @entity1514 multidisciplinary clinic. Thoracoscopy included nodal sampling from American @entity1514 Society levels 5, 6, 8, and 9 within the mediastinum. Laparoscopy included inspection of the liver and nodal sampling from the lesser curvature and the @entity1593 . Preoperative chemoradiation consisted of two cycles of @entity1487 (1000 mg/M2) and @entity900 (100 mg/M2) weeks 1 and 4 with 50.4 Gy. Radiotherapy was delivered at 1.8 Gy/fraction with 39.6 Gy being delivered to the large-field and 10.8 Gy to a small-field boost. The routine surgical procedure was an Ivor-Lewis esophagectomy performed 4 to 6 weeks after completion of induction therapy. RESULTS: The median follow up was 24 months for all @entity1 . The median overall survival was 23 months, with 1-, 2-, and 3-year survivals of 64%, 42%, and 34%, respectively. Thirty @entity1 had pathological evidence of @entity1600 before therapy. The pathological complete response rate for the entire group was 51%. Node-positive @entity1 had a path complete response rate of 14%, as compared with 59% for those who were NO. The median survival for these two groups was 15 months versus 35 months. @entity1 whose nodes were cleared by chemoradiation had a 3-year survival of 40%, whereas all @entity1 with persistent @entity66 were dead by 2 years. Twenty-one @entity1 have experienced recurrence of their disease. Thirteen @entity1 had evidence of distant @entity3 only, three local only, and five with both. CONCLUSION: Trimodality therapy offers @entity1 with @entity418 an opportunity for long-term survival. Our experience has shown that minimally invasive pretreatment surgical staging provides useful information that can predict complete response and can help in the selection of appropriate @entity1 for aggressive therapy.

Accurate lymph node assessment prior to trimodality therapy for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity1593 :: ('MESH:D002446', 'Disease') :: ['celiac axis'] @entity66 :: ('MESH:D004194', 'Disease') :: ['nodal disease'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['lymph node disease'] @entity1514 :: ('MESH:D013896', 'Disease') :: ['Thoracic', 'thoracic'] @entity418 :: ('MESH:D004938', 'Disease') :: ['esophageal cancer', 'esophageal carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity418 :: (MESH:D004938,Disease) :: ['esophageal carcinoma']
