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Nodal Status Key to Outcome After Chemoradiation for Esophageal Cancer

Michael Smith
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. | July 16, 2007
  • Explain to interested patients that the prognosis in esophageal cancer is not good, with a three-year survival rate of only 50%.

  • Using chemotherapy and radiation to reduce the extent of the cancer before surgery is a strategy that is winning increasing acceptance, but it is difficult to tell which patients will do well.

  • Note that this study suggests that a node-negative status after the neoadjuvant chemoradiation is the best predictor of the outcome of surgery.

DUBLIN, July16 -- For esophageal-cancer patients, a node-negative status after neoadjuvant chemoradiation is the best predictor of the outcome of surgery, researchers here found.

The finding is important because it shifts the focus from the primary tumor to the lymph nodes and may influence the way clinical trials are designed, according to John Vincent Reynolds, M.D., of St. James's Hospital and Trinity College Dublin and colleagues.

It also may help to clarify the "confused and conflicting" interpretations of randomized clinical trials of neoadjuvant chemoradiation therapy for esophageal cancer, Dr. Reynolds and colleagues reported in the May issue of Annals of Surgery.

Although clinicians widely believe there are patients for whom neoadjuvant chemoradiation therapy works well, identifying them is not easy, the researcher said.

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