Guidelines for diagnosis and treatment of carcinoma of the esophagus: April 2007 edition: Part II edited by the Japan Esophageal Society

Hiroyuki Kuwano, Yasumasa Nishimura, Atsushi Ohtsu, Hiroyuki Kato, Yuukou Kitagawa, Setsuo Tamai, Yasushi Toh, Hisahiro Matsubara

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Preoperative chemotherapy: there have been three reports of meta-analyses based on randomized controlled trials carried out in Europe or North America that compared surgical resection with preoperative chemotherapy and surgical resection alone. However, the conclusions are conflicting: one found that preoperative chemotherapy does not improve 1-year and 2-year survival rates, whereas the other showed preoperative chemotherapy to slightly improve the 2-year survival rate. At present, the efficacy of preoperative chemotherapy for resectable cases (T1-3, N0,1, M0; 2002 edition of UICC classification) is unclear. Preoperative chemoradiotherapy: the results of a meta-analysis of randomized controlled trials comparing surgery alone and surgery combined with preoperative chemoradiotherapy carried out in Europe and North America showed that preoperative concurrent chemoradiotherapy (20-45 Gy) for resectable cases (T1-3, N0,1, M0) caused a significant increase in operation-related mortality while significantly improving the 3-year survival rate. However, when the 1-year or 2-year survival rate was the endpoint, there was no clear survival benefit of preoperative chemoradiotherapy. Thus, the results of this meta-analysis of randomized controlled trials performed in Europe and North America suggest that preoperative chemoradiotherapy combined with surgery has the potential to improve the long-term survival of patients undergoing surgical resection of esophageal carcinoma. In Japan, this therapy is performed for locally advanced cases in a number of institutions. However, no high-level evidence is available concerning Japanese patients, and there is no firm basis for recommending the use of preoperative chemoradiotherapy in Japan.

Original languageEnglish
Pages (from-to)117-132
Number of pages16
JournalEsophagus
Volume5
Issue number3
DOIs
Publication statusPublished - 2008 Sep
Externally publishedYes

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Chemoradiotherapy
Esophagus
Japan
Guidelines
Carcinoma
Drug Therapy
Survival Rate
North America
Meta-Analysis
Randomized Controlled Trials
Therapeutics
Survival
Mortality

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Guidelines for diagnosis and treatment of carcinoma of the esophagus : April 2007 edition: Part II edited by the Japan Esophageal Society. / Kuwano, Hiroyuki; Nishimura, Yasumasa; Ohtsu, Atsushi; Kato, Hiroyuki; Kitagawa, Yuukou; Tamai, Setsuo; Toh, Yasushi; Matsubara, Hisahiro.

In: Esophagus, Vol. 5, No. 3, 09.2008, p. 117-132.

Research output: Contribution to journalArticle

Kuwano, Hiroyuki ; Nishimura, Yasumasa ; Ohtsu, Atsushi ; Kato, Hiroyuki ; Kitagawa, Yuukou ; Tamai, Setsuo ; Toh, Yasushi ; Matsubara, Hisahiro. / Guidelines for diagnosis and treatment of carcinoma of the esophagus : April 2007 edition: Part II edited by the Japan Esophageal Society. In: Esophagus. 2008 ; Vol. 5, No. 3. pp. 117-132.
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