tailieunhanh - báo cáo khoa học: "Chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer patients: is it time for additional evidence?"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer patients: is it time for additional evidence? | Cafarotti et al. World Journal of Surgical Oncology 2011 9 41 http content 9 1 41 5 2 CORRESPONDENCE WORLD JOURNAL OF SURGICAL ONCOLOGY Open Access Chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer patients is it time for additional evidence 1 1 1 1 Stefano Cafarotti Alfredo Cesario Venanzio Porziella Stefano Margaritora and Pierluigi Granone Abstract Recent efforts to improve survival in patients with locally advanced esophageal carcinoma have combined both systemic and local therapy. However the role of neoadjuvant chemoradiotherapy in technically operable IIa-III esophageal carcinoma is still unresolved. Findings We have read with interest the report from Hurmuzlu and coll 1 on the outcome of induction therapy IT plus surgery versus surgery alone in locally advanced operable esophageal cancer OC . The report is of great speculative interest given the consistently poor prognosis of OC whatever the therapeutic strategy adopted so far in fact there is no general consensus on the appropriate treatment for such a dreadful condition. Specifically the role of chemo-radiotherapy administered pre-operatively in resectable cstage IIa-III OC is still discussed. Scarce data are available from the literature and these are not consistent. In fact some experiences 2 3 conclude with positive recommendations to adopt the trimodality approach and others 4 conclude with opposite position that IT should not be adopted in OC that are resectable following the clinical staging assessment. As already advocated by Pereira 5 the indication for IT for resectable OC remains largely not evidence-based substantially due to methodological biases in the trials that can be summarised as follows different tumour stages included no standardized preoperative diagnostic procedure and last but not least the great heterogenity of surgical treatment. In this scenario of substantial absence of a large base of methodologically correct evidence and agreed .