Postoperative Adjuvant Chemotherapy for Thoracic Esophageal Carcinoma

Hideaki Yamana

Department of Surgery, Kurume University, School of Medicine

To compare the adjuvant effect of radiation therapy and chemotherapy after curative resction for patients with esophageal squamous cell carcinoma, a prospective randomized study was performed by Japan Esophageal Oncology Group (JEOG) between 1984 and 1987. In this study, postoperative survival curves showed no significant difference between the two groups. Therefore, JEOG also performed a randomized trial between surgery alone and postoperative chemotherapy between 1988 and 1991. There was no significant difference in survivals between the two groups. In cases with lymph node metastasis positive, however, postoperative chemotherapy group showed a tendency of good survival (p=0.134) in comparison with surgery alone group. Adversely, a better survival was found in surgey alone group in patients with no lymph node metastasis, but it had no statistical significant difference (p=0.215). This result suggest that postoperative chemotherapy with more effective anti-cancer drugs may improve patients' prognosis and impresses that radically resected cases with no lymph node metastasis may not require adjuvant chemotherapy. On the other hand, co-operative study of anti-cancer drug sensitivity test was done by using adhesive tumor cell culture system. Although no correlation was found between the drug sensitivity and clinical effects, further studies on useful drug sensitivity tests are needed.

Key words
esophageal carcinoma, randomized controlled study, chemotherapy

Reprint requests
Hideaki Yamana Department of Surgery, Kurume University, School of Medicine
67 Asahimachi, Kurume, 830-0011 JAPAN

Accepted
May 19, 1998

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