Outcome of Surgery for Oesophageal Carcinoma in a Low Volume Centre, with and without Preoperative Chemoradiotherapy

Abstract

Aims: To critically assess the outcome of surgery for oesophageal carcinoma, with or without neoadjuvant chemoradiotherapy. Methods: Since April 1998 until August 2002 resectable oesophageal cancer patients referred to us have received multimodal treatment, consisting of two courses of fluorouracil, cisplatin and hydroxyurea and 20 Gy of radiotherapy followed by surgery. The outcome of this treatment was compared to the outcome of a historical group of oesophageal cancer patients, treated with surgery alone in the time period 1994 to 1998. The patients represent a consecutive series of 20 resectable oesophageal carcinomas, referred to us since 1994. Four patients (20 %) were treated for squamocellular carcinoma, 16 (80 %) patients for adenocarcinoma. Results: Treatment related toxicity was low and there was no death attributable to the chemoradiotherapy. Postoperative hospital mortality (< 30 days) and morbidity rates were 10 % and 50 %, respectively. A complete pathological response (T0) occurred in two of the nine patients in the multimodal group (22 %). Overall median survival was 11 months. Median survival among patients in the multimodal group was 14 months, as compared with 7 months in the group treated with surgery alone (P = 0.041). Conclusions: Despite low volume, outcome of surgery for oesophageal carcinoma was acceptable.