| Abstract: |
Preoperative chemotherapy for localized esophageal cancer is an area of increasing interest because neither surgery nor radiation has had a major impact on disease-free or overall survival. This is probably because, as several autopsy series have demonstrated, esophageal cancer is a systemic disease. Preoperative chemotherapy thus, in theory, allows a simultaneous attack on both the primary and metastatic disease. A number of single-arm, Phase II, multimodality trials have been completed. Toxicities of chemotherapy, while substantial, have been tolerable. With careful attention to detail, operative morbidity and mortality have not been increased. Although the theory is attractive, large-scale randomized trials are now needed to evaluate the impact of this technique on disease-free and overall survival before recommending it for general use. © 1987 Société Internationale de Chirurgie. |
