To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Neoadjuvant Therapy May Mask Extent of Oesophageal Cancer: Presented at ACS URL: http://www.pslgroup.com/dg/22EEBE.htm Doctor's Guide October 16, 2008
By Roberta Friedman, PhD SAN FRANCISCO -- October 16, 2008 -- In patients with oesophageal cancer, neoadjuvant therapy may mask the extent of disease, according to a study that found better survival in patients who did not receive chemotherapy or radiation prior to undergoing oesophagectomy. Currently, patients are assigned to receive neoadjuvant therapy despite lack of evidence, in terms of survival benefit, to support this approach, said Shahin Ayazi, MD, Department of Surgery, University of Southern California, Los Angeles, California. Dr. Ayazi and colleagues looked at data from 100 patients with oesophageal cancer but no evidence of metastasis who were treated from 1991 through 2007. He presented the results here on October 15 at the American College of Surgeons (ACS) 94th Annual Clinical Congress. In 25 patients, neoadjuvant chemotherapy was administered prior to oesophagectomy, while oesophagectomy was performed without neoadjuvant chemotherapy in the other 75 patients. Tissue was removed en bloc and follow-up was every 3 months for 3 years, then every 6 months up to 5 years. Recurrence was seen in 8% of patients treated with surgery alone and in 16% of those who had neoadjuvant therapy prior to oesophagectomy (P < .008). These "surprising results" show, Dr. Ayazi said, that "the problem is the inaccuracy of clinical staging" of the disease. He added, "There is room for improvement." He noted that dysphagia is an indicator of advanced disease. Jeffrey A. Hagen, MD, Thoracic/Foregut Surgery, University of California Medical Center, the senior author of the study, said that nodes found negative at surgery may in fact have had cancer in them before neoadjuvant therapy; this, he said, was the root of the problem. "Patients who don't survive may have had more tumour and were [therefore inaccurately] downstaged," he concluded. Patients such as these would need more therapy after surgery. Dr. Hagen said. "Those who had surgery alone without prior chemotherapy or radiation and whose nodes [were] clear will do fine." [Presentation title: Comparison of Survival in Patients With Lymph Node Negative Adenocarcinoma of the Esophagus After R0 Resection With and Without Neoadjuvant Therapy. Session GS66] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.