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Multimodality treatment for esophageal cancer - Surgery, is it necessary?

Research Project

Project/Area Number 15591459
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Digestive surgery
Research InstitutionKurume University

Principal Investigator

FUJITA Hiromasa  Kurume University, School of Medicine, Professor, 医学部, 教授 (90156878)

Co-Investigator(Kenkyū-buntansha) SUEYOSHI Susumu  Kurume University, School of Medicine, Assistant professor, 医学部, 助教授 (30235840)
TANAKA Toshiaki  Kurume University, School of Medicine, Lecturer, 医学部, 講師 (20227151)
TANAKA Yuichi  Kurume University, School of Medicine, Assistant, 医学部, 助手 (50268900)
SASAHARA Hiroko  Kurume University, School of Medicine, Assistant, 医学部, 助手 (10279185)
SUZUKI Gen  Kurume University, School of Medicine, Assistant, 医学部, 助手 (80279182)
田中 健  久留米大学, 医学部, 講師 (60217023)
Project Period (FY) 2003 – 2006
Project Status Completed (Fiscal Year 2006)
Budget Amount *help
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2006: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2005: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 2004: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2003: ¥900,000 (Direct Cost: ¥900,000)
KeywordsCancer in the thoracic esophagus / Multimodality treatment / Esophagectomy / Definitive chemoradiotherapy / Neoadjuvant therapy / Potentially-resectable cancer / Cancer at the intermediate stage / Informed consent / Neoadluvant療法 / 修学治療 / 根治的放射線化学療法
Research Abstract

Purpose : To compare the outcomes after esophagectomy versus those after chemoradiotherapy for potentially respectable (T2-3,NO-1,MO) esophageal cancer
Materials:
1) squamous cell carcinoma in the thoracic esophagus
2) potentially respectable cancer, cT2-3, cNO-1, cMO, cStage II-III
3) patients at a low risk for both esophagectomy and definitive chemoradiotherapy
4) no double primary cancers
5) obtaining informed consent
Methods : Patients choose one arm among the following three treatment arms after informed consent.
1) esophagectomy (S)
2) definitive chemoradiotherapy (CRT)
3) neoadjuvant chemoradiotherapy (NA) ; Patients choose surgery or non-surgical treatment after being informing of the response to the neoadjuvant chemoradiotherapy
Results : A hundred and two patients participated in this trial, from 2003 to 2006. There were 76 patients in the esophagectomy (S) group, 18 in the definitive chemoradiotherapy (CRT) group, and 8 in the neoadjuvant chemoradiotherapy (NA) group.
1) S Group : There … More were 59 patients who underwent Ro resection, 16 who underwent R1R2 resection, and one who underwent only exploratory thoracotomy. The 1-, 2-, and 3-year-survival rate was 81%, 56%, and 49%, respectively in the S Group.
2) CRT Group : There were 14 patients with complete response, and 4 with incomplete response. There was no patient who underwent salvage surgery. The 1-, 2-, and 3-year-survival rate was 89%, 68%, and 46%, respectively in the CRT Group.
3) NA Group : There were three patients who underwent esophagectomy, and five who did not. The 1-, and 2-year-survival rate was 50% and 50%, respectively in the NA Group.
The 1-, 2-, and 3-year-survival rate was 81%, 56%, and 49%, respectively in those patients who chose the surgical treatment at first, and was 74%, 60%, and 40%, respectively in those patients who chose the non-surgical treatment at first (the CRT Group + the NA Group)
Conclusions : The outcomes after chemoradiotherapy for potentially respectable (T2-3,NO-1,MO) esophageal cancer may be similar to those after surgery. Less

Report

(5 results)
  • 2006 Annual Research Report   Final Research Report Summary
  • 2005 Annual Research Report
  • 2004 Annual Research Report
  • 2003 Annual Research Report
  • Research Products

    (50 results)

All 2007 2006 2005 2004 2003 Other

All Journal Article (47 results) Book (1 results) Publications (2 results)

  • [Journal Article] 「食道癌に対するless invasive surgeryの工夫:開胸手術と鏡視下手術」 開胸手術 開胸・開腹2007

    • Author(s)
      末吉晋, 田中寿明, 藤田博正ほか
    • Journal Title

      消化器外科 30巻・2号

      Pages: 133-140

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 「食道癌・胃癌手術の標準的リンパ節郭清術:How to do it?」 頸部食道癌の標準的リンパ節郭清術2007

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      手術 61巻・3号

      Pages: 259-264

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 頸部食道癌手術2006

    • Author(s)
      藤田博正, 森直樹
    • Journal Title

      手術 60(6)

      Pages: 699-706

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] 頭頸部がん 頸部食道がん2006

    • Author(s)
      藤田博正, 森直樹, 千々和秀記ほか
    • Journal Title

      臨床腫瘍プラクティス 2(3)

      Pages: 255-259

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] 左開胸開腹下部食道噴門切除・胸腔内胃管再建術2006

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      臨床外科 61(11)

      Pages: 31-41

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Surgery of cancer in the cervical esophagus2006

    • Author(s)
      H Fujita, N Mori
    • Journal Title

      Syuzyutu (Surgery) 60(6)

      Pages: 699-706

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Surgical procedure for cancer in the cervical esophagus2006

    • Author(s)
      H Fujita, N Mori, H Chijiwa
    • Journal Title

      Rinsyo syuyou practice (The Practice of Medical Oncology) 2(3)

      Pages: 255-259

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Esophagogastrostomy following lower esophagectomy with proximal gastrectomy through a left thoracoabdominal incision2006

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      Rinsyo Geka (Clinical surgery) 61(11)

      Pages: 31-41

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] パネルディスカッション「頸部食道癌の外科治療」司会者のまとめ2006

    • Author(s)
      藤田博正
    • Journal Title

      日本気管食道科学会会報 57巻・2号

      Pages: 109-110

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 頸部食道癌のリンパ節転移に対する臨床的検討2006

    • Author(s)
      千々和秀記, 進武一郎, 藤田博正ほか
    • Journal Title

      日本気管食道科学会会報 57巻・3号

      Pages: 277-282

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 臨床解剖から見た手術のシークレット「頸部食道癌手術」2006

    • Author(s)
      藤田博正, 森直樹
    • Journal Title

      手術 60巻・6号

      Pages: 699-706

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Small cell carcinoma in the esophagus rapidly developing multiple fistulae2006

    • Author(s)
      Naoki Mori, Hiromasa Fujita, Susumu Sueyosi, et al.
    • Journal Title

      Esophagus Vol.3

      Pages: 7-12

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 再発食道癌に対するPDT2006

    • Author(s)
      末吉晋, 笹原弘子, 藤田博正ほか
    • Journal Title

      胃と腸 41巻・4号

      Pages: 499-499

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 治療方法の進歩による下咽頭癌治療成績の向上2006

    • Author(s)
      梅野博仁, 千々和秀記, 藤田博正ほか
    • Journal Title

      日本気管食道科学会会報 57巻・4号

      Pages: 363-370

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 頭頸部がん手術 頸部食道がん2006

    • Author(s)
      藤田博正, 森直樹, 千々和秀記
    • Journal Title

      臨床腫瘍プラクティス 2巻・3号

      Pages: 255-259

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Thoracic and cardiovascular surgery in Japan during 2004 Annual report by the Japanese Association for Thoracic Surgery.2006

    • Author(s)
      Teruhisa Kazui, Hiroaki Osada, Hiromasa Fujita
    • Journal Title

      Jpn J Thoracic Cardiovasc Surg. Vol.54・No.8

      Pages: 363-386

    • NAID

      10018331953

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 進行・再発胸部食道癌症例に対するステント治療成績2006

    • Author(s)
      田中寿明, 末吉晋, 藤田博正ほか
    • Journal Title

      日本消化器外科学会雑誌 39巻・9号

      Pages: 1465-1471

    • NAID

      110004793264

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 左開胸開腹下部食道噴門切除・胸腔内胃管再建術2006

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      臨床外科 61巻・11号

      Pages: 31-41

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 癌治療とクリニカルパス2006

    • Author(s)
      田中寿明, 遠坂タエ子, 藤田博正
    • Journal Title

      癌と化学療法 33巻・11号

      Pages: 1568-1570

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Summaries from the 60^<th> Annual Meeting of the Japan Esophageal Society June 30-July 1, 2006, Tokyo2006

    • Author(s)
      Hiromasa Fujita, Tadakazu Shimoda
    • Journal Title

      Esophagus Vol.3・No.4

      Pages: 187-188

    • Related Report
      2006 Annual Research Report
  • [Journal Article] エビデンスに基づいた癌化学療法 食道癌2005

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      外科 67(4)

      Pages: 396-400

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Esophagectomy; is it necessary after chemoradiotherapy for a locally advanced T4 esophageal cancer? Prospective nonrandomized trial comparing chemoradiotherapy with surgery versus without surgery2005

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      World J Surg 29(1)

      Pages: 25-30

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Quo vadis, esophageal surgery?2005

    • Author(s)
      H Fujita
    • Journal Title

      Jpn J Thorac Cardiovasc Surg 53(5)

      Pages: 235-236

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Prospective non-randomized trial comparing esophagectomy-followed-by-chemoradiotherapy versus chemoradiotherapy-followed-by-esophagectomy for T4 esophageal cancers2005

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      J Surg Oncol 90(4)

      Pages: 209-219

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Chemotherapy for esophageal cancer based on evidences2005

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      Geka (Surgery) 67(4)

      Pages: 396-400

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Esophagectomy ; is it necessary after chemoradiotherapy for a locally advanced T4 esophageal cancer? Prospective nonrandomized trial comparing chemoradiotherapy with surgery versus without surgery2005

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      World J Surg 29(1)

      Pages: 25-30

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] esophageal surgery?2005

    • Author(s)
      H Fujita, Qua vadis
    • Journal Title

      Jpn J Thorac Cardiovasc Surg 53(5)

      Pages: 235-236

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Prospective non-randomized trial comparing esophagectomy-followed-by-chemoradiotherapy versus chemoradiotherapy-followed-by-esophagectomy for T4 Esophageal cancers2005

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      J Surg Oncol 90(4)

      Pages: 209-219

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] エビデンスに基づいた癌化学療法、食道癌2005

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      外科 67巻・4号

      Pages: 396-400

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Esophagectomy : is it necessary after chemoradiotherapy for a locally advanced T4 esophageal cancer? Prospective nonrandomized trial comparing chemoradiotherapy with surgery versus without surgery2005

    • Author(s)
      Hiromasa Fujita, Susumu Sueyoshi, Toshiaki Tanaka, Yuichi Tanaka, Satoru Matono, Naoki Mori, Kazuo Shirouzu, et al.
    • Journal Title

      World J Surg Vol.29・1

      Pages: 25-30

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Quo Vadis, Esophageal Surgery?2005

    • Author(s)
      Hiromasa Fujita
    • Journal Title

      Jpn J Thorac Cardiovasc Surg Vol.53・5

      Pages: 235-236

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Prospective non-randomized trial comparing esophagectomy-followed-by-chemo-Radiotherapy versus chemoradiotherapy-followed-by-esophagectomy for T4 esophageal cancers2005

    • Author(s)
      Hiromasa Fujita, Susumu Sueyoshi, Toshiaki Tanaka, Yuichi Tanaka, Hiroko Sasahara, Kazuo Shirouzu, et al.
    • Journal Title

      J Surg Oncol Vol.90・4

      Pages: 209-219

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 胸部食道癌手術におけるHALS (hand-assisted laparoscopic surgery)の有用性2005

    • Author(s)
      田中寿明, 末吉晋, 笹原弘子, 田中優一, 白水和雄, 藤田博正
    • Journal Title

      日本内視鏡外科学会雑誌 10巻・2号

      Pages: 197-202

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 食道癌のhand-assisted laparoscopic surgery2005

    • Author(s)
      末吉晋, 田中寿明, 藤田博正, 白水和雄
    • Journal Title

      外科 67巻・13号

      Pages: 1673-1677

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 食道癌手術にける胸部大動脈周囲のリンパ節郭清術2004

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      手術 58(1)

      Pages: 7-11

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Present status of esophageal cancer and its treatment in Japan2004

    • Author(s)
      H Fujita
    • Journal Title

      Ann Thorac Cardiovasc Surg 10(3)

      Pages: 135-139

    • NAID

      10020416527

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Dissection of the lymph nodes along the thoracic aorta in esophageal cancer surgery2004

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      Syuzyutu (Surgery) 58(1)

      Pages: 7-11

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Present status of esophageal cancer and its treatment in Japan2004

    • Author(s)
      Hiromasa Fujita
    • Journal Title

      Ann Thorac Cardiovasc Surg 10・3

      Pages: 135-139

    • NAID

      10020416527

    • Related Report
      2004 Annual Research Report
  • [Journal Article] A phase II study of single-agent docetaxel in patients with metastatic esophageal cancer.2004

    • Author(s)
      K.Muro, H.Fujita, T.Ohtsu, et al.
    • Journal Title

      Ann Oncol 15

      Pages: 955-959

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 他臓器浸潤食道癌に対する集学的治療2004

    • Author(s)
      末吉晋, 藤田博正, 田中寿明, 白水和雄
    • Journal Title

      外科 66・11

      Pages: 1272-1275

    • Related Report
      2004 Annual Research Report
  • [Journal Article] Esophagectomy : is it necessary after chemoradiotherapy for a locally advanced T4 esophageal cancer? Prospective nonrandomized trial comparing chemoradiotherapy with surgery versus without surgery.2004

    • Author(s)
      H.Fujita, S.Sueyoshi, T.Tanaka, et al.
    • Journal Title

      World J Surg 28・12

    • Related Report
      2004 Annual Research Report
  • [Journal Article] Optimal lymphadenectomy for squamous cell carcinoma in the thoracic esophagus; comparing the short- and long-term outcome among the four types of lymphadenectomy2003

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      World J Surg 27(5)

      Pages: 571-579

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] 食道癌のchemoradiotherapy2003

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      癌と化学療法 30(7)

      Pages: 937-943

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] T4食道癌治療における外科的切除の意義2003

    • Author(s)
      藤田博正, 末吉晋, 田中寿明ほか
    • Journal Title

      臨床消化器内科 18(11)

      Pages: 1515-1521

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Optimal lymphadenctomy for squamous cell carcinoma in the thoracic esophagus ; comparing the short-and long-term outcome among the four types of lymphadenectomy2003

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      World J Surg 27(5)

      Pages: 571-579

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Chemoradiotherapy for esophageal cancer2003

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      Gann to Kagakuryoho (Cancer and chemotherapy) 30(7)

      Pages: 937-943

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Journal Article] Significance of surgery in the treatment for T4 esophageal cancer2003

    • Author(s)
      H Fujita, S Sueyoshi, T Tanaka, et al.
    • Journal Title

      Rinnsyo Syokaki Naika (Clinical Gastroenterology) 18(11)

      Pages: 1515-1521

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2006 Final Research Report Summary
  • [Book] 胸部外科において何が標準手術となりうるか2007

    • Author(s)
      日本胸部外科学会卒後教育委員会(委員長 藤田博正)
    • Total Pages
      269
    • Publisher
      日本胸部外科学会
    • Related Report
      2006 Annual Research Report
  • [Publications] 藤田博正, 末吉晋, 田中寿明, 他: "食道癌のChemoradiotherapy"癌と化学療法. 30・7. 937-943 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 藤田博正, 末吉晋, 田中寿明, 他: "食道癌の治療戦略-手術か、化学放射線療法か-"日本癌治療学会雑誌. 38・2. 270 (2003)

    • Related Report
      2003 Annual Research Report

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Published: 2003-04-01   Modified: 2016-04-21  

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