Pre-op treatments boost survival for esophageal cancer patients: study
Experts say adding chemo, radiation before surgery is now standard treatment for most with the disease.
(HealthDay) -- Patients with esophageal cancer who receive chemotherapy and radiation before surgery have better outcomes, Dutch researchers report.
"We think that patients with esophageal cancer have the best chance to survive this cancer when they are treated with preoperative chemo-radiotherapy followed by surgery," said lead researcher Dr. Ate van der Gaast, from the medical oncology department at Erasmus University Hospital in Rotterdam. "By giving preoperative chemo-radiotherapy, more patients are cured than with surgery alone."
In the United States, more than 17,000 people will be diagnosed with esophageal cancer and more than 15,000 will die from it this year, according to the American Cancer Society.
For the study, published in the May 31 issue of the New England Journal of Medicine, the Dutch team randomly assigned nearly 400 people with esophageal cancer either to surgery alone or chemotherapy and radiation before surgery.
The researchers found patients who received chemotherapy before surgery lived an average of four years, while those who went straight to surgery lived an average of two years. More patients in the chemotherapy group had a complete response to treatment and had more of the cancer removed during surgery than those who had surgery alone, the team also noted.
Complications after surgery were similar in both groups, and 4 percent of patients in each group died in the hospital after the procedure, the researchers added.
Dr. Raja Flores, chief of thoracic surgery at Mount Sinai Hospital in New York City, said "these findings were what everyone expected, but not to the degree it came out."
With esophageal cancer, removing the cancer from the area around the tumor is key to treatment. Chemotherapy and radiation is performed before surgery to help contain the cancer so more of it can be removed during the operation, Flores explained.
This approach is becoming standard therapy, he said, "but this study gives the proof positive that that's the way it should go."
Flores said although the treatment adds initial cost, it can save money. "If it leads to more cures, it's going to save money," he said.
Patients need to make sure this approach is discussed with them "so they just don't run straight to surgery," Flores said.
Dr. Harvey Mamon is clinical director of the department of radiation oncology at Brigham and Women's Hospital and Dana Farber Cancer Institute in Boston. He said: "This is an important and well-done study that will influence practice patterns. For all intents and purposes, the standard of care for locally advanced esophageal cancer was already preoperative chemo-radiation followed by surgery."
The significant improvement in the chemo-radiation portion in this trial confirms this current standard of care, he said. "I don't think we're likely to see further trials of surgery alone versus surgery following chemo-radiation."
More information: For more information on esophageal cancer, visit the U.S. National Cancer Institute.
Journal reference: New England Journal of Medicine
Copyright © 2012 HealthDay. All rights reserved.
- Combination therapy spares some head and neck patients from surgery Jan 19, 2007 | not rated yet | 0
- Preoperative radiation may improve survival rates in advanced rectal cancer patients Dec 02, 2008 | not rated yet | 0
- Many lung cancer patients get radiation therapy that may not prolong their lives Feb 13, 2012 | not rated yet | 0
- Combining radiation and surgery significantly improves survival for head and neck cancer patients Jun 09, 2008 | not rated yet | 0
- Does BMI affect post-surgical complications, survival in esophageal adenocarcinoma? Mar 28, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer 7 hours ago | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer 7 hours ago | not rated yet | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer 11 hours ago | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer 11 hours ago | 5 / 5 (1) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer 12 hours ago | 5 / 5 (3) | 0
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
5 hours ago | 5 / 5 (1) | 0 |
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
11 hours ago | 5 / 5 (3) | 0 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
8 hours ago | 5 / 5 (1) | 0 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
8 hours ago | 5 / 5 (2) | 0 |
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
5 hours ago | not rated yet | 0
Kate O'Reilly's spring allergy survival kit includes the usual stuff - nasal sprays, allergy pills and a box of tissues. This season, she's added a new weapon to her line of defense: an app on her smartphone.
6 hours ago | not rated yet | 0