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Revista do Colégio Brasileiro de Cirurgiões
Print version ISSN 0100-6991
MIRRA, Antonio Pedro; JUSTO, Fernando Antonio; SCHNEIDER, Carlos Alberto Rodrigues and TRIPPE, Nivaldo. Treatment of cancer of the esophagus: clinical trial. Rev. Col. Bras. Cir. [online]. 1998, vol.25, n.2, pp. 119-122. ISSN 0100-6991. http://dx.doi.org/10.1590/S0100-69911998000200009.
A 65-case-clinical trial on esophagus cancer was conducted at the Hospital A.C. Camargo between 1986 and 1990. A controlled clinical trial studied three therapeutic groups, as follows: group 1 - surgery alone (20 cases); group 2 - surgery plus postoperative radiotherapy (27 cases); and group 3 - preoperative chemotherapy plus surgery followed by postoperative radiotherapy and chemotherapy (18 cases). Surgery occurred in a one-step procedure with large ressection of the esophagus, mainly by transpleural access to tumors in the middle third and transmediastinal to the lower third and abdominal segment of the esophagus. Included in the same surgical procedure was the removal of regional lymph nodes as well as the reconstruction using the stomach, with extrathoracic cervical anastomosis and stomach placement into the posterior mediastinum. Radiotherapy was employed at the posterior mediastinum in a total dose of 4.500-5.000 cGY applied in five sessions. Cisplatin (800 mg/m2), vincristine (1.5 mg/m2) and bleomicine (10 mg/m2) were administered through pre and postoperative chemotherapy regimen. A 5-year survival was observed in 61.9% of the group 1 cases; 52.6% of the group 2 cases and 68.7% of the group 3 cases. Relative to clinical staging, this survival was of 52.0% for clinical stage I + II A and 45.5% for clinical stage II B + III These results were not statiscally significant. Five-year survival rates for groups 1 and 2 ranged from 40.4% to 60.6% when clinical stages were I + II A; the other stages did not present a 5-year survival. For better assessment, a greater number of cases is necessary. This would be achieved if more esophageal cancer services entried in similar clinical trials.
Keywords : Esophageal cancer; Esophagectomy.