Multimodal treatment for oesophageal primary cancer. A preliminary study

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COD: 05_2009_351-356 Categorie: ,

Duilio Divisi, Margherita Garramone, Gabriella Di Leonardo, Daniela Valente, Guido Torresini, Gabriele Di Giacopo, Berardo De Berardis, Roberto Crisci

Ann. Ital. Chir., 2009; 80: 351-356

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OBJECTIVE: This study examines the role of chemoradiotherapy, surgical reconstructive techniques of the esophagus and
lymphadenectomy in relation to morbidity and mortality.
METHODS. From January 2005 to January 2008 we observed 18 patients with esophagus cancer. Eleven patients manifested
a lesion of the middle thirdy , 4 patients had a lesion of the upper third and 3 patients had a lesion of the
lower third. Preoperative histological evaluation revealed 3 adenocarcinomas and 15 squamous carcinomas. Four patients
with a lesion of the upper third received neoadjuvant chemotherapy.
RESULTS: In 13 patients reconstruction used stomach and 5 patients underwent reconstruction with the colon.
Complications ensued in 3 of the latter: dehiscence of the anastomosis, anastomotic stenosis and chylothorax. Three patients
highlighted a moderate malabsorption syndrome. A T3N1M0 patient received postoperative cisplatin/5-fluorouracil and
radiation therapy.
CONCLUSIONS: The use of the stomach represents the therapeutic gold standard for minimized incidence of complications.
Lymphadenectomy allows to establish a precise stage of cancer. Chemoradiotherapy is recommended in case of risk of
relapse.

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