| Abstract
| - To improve resectability for bulky esophageal tumors and/or tumorsevolving close to the pharyngo-esophageal junction (PEJ), a combinedpreoperative chemotherapy plus radiotherapy (CT+RT) was given in 25patients. There were 23 men and 2 women (mean age: 55 years); 21 hadsquamous cell carcinoma and 4 had adenocarcinoma. According to TNMclassification based on computed tomography, the tumor was graded T3 in 20cases, T4 in 2, T2 in 2 and T1 in 1. The preoperative treatment includedtwo sessions of continuous infusion of 5-fluorouracil (800 mg/m2 per day)and cisplatin (20 mg/m2 per day), and combined radiotherapy (3 Gy/day). Theoverall tolerance was acceptable. The tumoral mass decreased in 23 patients(92%). All the patients underwent a wide esophagectomy; among the sixpatients with a tumor close to the PEJ, two required an associatedpharyngolaryngectomy. The operative mortality rate was 8%. Major non-fatalcomplications occurred in 52%. On histology, there was no evidence ofresidual disease in seven patients (28%). The median survival was 18 monthsand the overall survival rate was 22.1% at 2 years. For the patients whohad a complete histological response, the 2-year survival rate was 35%. Ourdata suggest that combined CT+RT may improve resectability of esophagealcarcinoma. Improved survival rates seem to be appreciable in patients witha complete histologic response.
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