Adding esophagectomy to chemoradiotherapy in locally advanced esophageal squamous cell carcinoma has little or no impact on overall survival, according to a Cochrane review of 2 randomized trials involving 431 individuals. Moreover, it may be linked with higher treatment-related mortality. Among the findings:
- Adding surgery reduced the risk that cancer would come back at the primary site.
- It did not improve overall survival.
- There were more treatment-related deaths in patients who underwent surgery, vs those who didn’t.
The authors noted that adding esophagectomy probably delays locoregional relapse, but this end point was not well defined. They added that it is not known if these results can be applied to the treatment of adenocarcinomas, tumors of the distal esophagus and gastroesophageal junction, or to those who respond poorly to chemoradiation.
Vellayappan B, Soon Y, Ku G, Leong C, Lu J, Tey J. Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer. Cochrane Database of Systematic Reviews. 2017, Issue 8. Art. No.: CD010511. doi:10.1002/14651858.CD010511.pub2.
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Must Reads in Head & Neck Cancers
Head and neck cancer therapy toxicities greater in women, Cristina V et al. JAMA Oncol. 2018 May 24. doi: 10.1001/jamaoncol.2018.1080.
CYCORE reduces radiotherapy side effects in head and neck cancers, Peterson et al. ASCO 2018, Abstract 6063
Metastatic Lymph Nodes and Oral Cancer Survival , J Clin Oncol; ePub 2017 Sep 7; Ho, Kim, et al
Surgery Plus Chemoradiotherapy for Esophageal Ca, Cochrane; 2017 Aug 22; Vellayappan, et al
Esophageal Ca Changes to the AJCC Staging Manual, CA Cancer J Clin; 2017 May 26; Rice, Gress, et al