Abstract
Background
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.
Methods
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.
Results
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 39Β·3 and 60Β·2 per cent respectively. Operative morbidity rates were 42Β·9 and 44Β·4 per cent after surgery alone and CS respectively. Thirty-day mortality rates were zero, 7Β·9 and 0Β·8 per cent after dCRT, surgery alone and CS respectively. Overall 2-year survival rates were 44Β·3, 56Β·2 and 42Β·4 per cent (P = 0Β·422).
Conclusion
These findings support the need for a randomized trial of dCRT versus CS for resectable oesophageal cancer.