Extended survival time for esophageal cancer patients treated with aggressive surgery and concurrent chemoradiation.

In attempts to improve overall long-term survival of patients with esophageal cancer, including medically inoperable patients and operable ones with disseminated disease, we treated operable patients with aggressive surgery and postoperative chemoradiation, and inoperable patients with chemoradiation alone. Chemoradiation consisted of 5,000-6,000 cGy of radiation and two courses of chemotherapy (cisplatin, vindesine, and pepleomycin). Of 90 patients seen between 1986 and 1991, 63 operable patients underwent surgery and 35 received postoperative chemoradiation, while 19 of 27 inoperable patients received chemoradiation. Results were compared with those of 48 unselected historical control patients treated since 1981. Survival at 5 years was significantly improved for the multimodality group (17.7 +/- 5.0%), as compared with the historical control group (10.4 +/- 4.4%). Thus, the overall therapy for patients with esophageal cancer has been improved.