Multimodal treatment for oesophageal primary cancer. A preliminary study
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Abstract
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.