The Editors have satisfied themselves that all authors have contributed significantly to this publication
Version of Record online: 21 OCT 2009
Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 96, Issue 11, pages 1300–1307, November 2009
How to Cite
Morgan, M. A., Lewis, W. G., Casbard, A., Roberts, S. A., Adams, R., Clark, G. W. B., Havard, T. J. and Crosby, T. D. L. (2009), Stage-for-stage comparison of definitive chemoradiotherapy, surgery alone and neoadjuvant chemotherapy for oesophageal carcinoma. Br J Surg, 96: 1300–1307. doi: 10.1002/bjs.6705
Presented to meetings of the 8th World Congress for Specialised Studies of the Esophagus, Avignon, France, September 2006, and the Association of Surgeons of Great Britain and Ireland, Manchester, UK, April 2007, and published in abstract form as J Clin Gastroenterol 2006; 40(8 Suppl 4): S213 and Br J Surg 2007, 94(S2): 25.
- Issue online: 21 OCT 2009
- Version of Record online: 21 OCT 2009
- Manuscript Accepted: 1 MAY 2009
Definitive chemoradiotherapy (dCRT) has been proposed as an alternative therapy for selected patients with oesophageal cancer. The aim of this study was to determine the outcomes of dCRT, surgery alone, and neoadjuvant chemotherapy followed by surgery (CS) in patients with oesophageal cancer.
Consecutive patients diagnosed with oesophageal cancer and managed by a multidisciplinary team were staged by computed tomography and endoluminal ultrasonography. Those deemed unsuitable for surgery on the grounds of performance status, bulky local disease or personal choice received dCRT. The primary outcome measure was overall survival measured from date of diagnosis.
Of 417 patients, 173 received dCRT, 126 underwent surgery alone and 118 received CS. The incidence of grade III/IV toxicity after dCRT and CS was 39·3 and 60·2 per cent respectively. Operative morbidity rates were 42·9 and 44·4 per cent after surgery alone and CS respectively. Thirty-day mortality rates were zero, 7·9 and 0·8 per cent after dCRT, surgery alone and CS respectively. Overall 2-year survival rates were 44·3, 56·2 and 42·4 per cent (P = 0·422).
These findings support the need for a randomized trial of dCRT versus CS for resectable oesophageal cancer. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.