Effects of neoadjuvant radiochemotherapy on pathological staging and prognosis for locally advanced XXXX .

@entity1 @entity5 @entity1721 @entity418 @entity3 @entity6830
The role of neoadjuvant therapy in the treatment of locally advanced @entity418 still remains controversial. The aim of this study was to evaluate the effects of neoadjuvant radiochemotherapy on pathological staging and prognosis in the @entity1 with locally advanced @entity1721 . Between January 1991 and December 2000, 473 @entity1 with advanced @entity418 diagnosed by endoscopic biopsy underwent surgical resection in our center. With informed consent, they were randomized into four groups: neoadjuvant chemotherapy, neoadjuvant radiotherapy, neoadjuvant radiochemotherapy, and surgery alone (control group). The preoperative computed tomography staging criteria were the following: Stage I, the @entity5 limited to the esophageal lumen or the thickness of the esophageal wall varied between 3-5 mm; Stage II, the thickness exceeds 5 mm but no invasion to the @entity6830 or distant @entity3 ; Stage III, the @entity5 invades adjacent mediastinal structure; and Stage IV, there is distant @entity3 . The @entity5 resection rate, pathological stage, treatment-related complication, and survival among groups were compared. The radical resection rate for the @entity1 in radiotherapy and radiochemotherapy groups was increased in comparison with the control group (P < 0.05). Their pathological stage after esophagectomy was regressed significantly than that of the control group (50.85%, 55.08% vs. 0%, P < 0.05). The adjuvant chemotherapy group did show significant improvement on resection rate and pathological staging compared with the control group. The treatment-related complication in the three neoadjuvant groups had no significant difference from that of the control group (P > 0.05). The 3-year survival rate of radiotherapy and radiochemotherapy groups were significantly higher than that of the control group (69.49%, 73.73% vs. 53.38%, P < 0.05). The 5-year survival rate of radiochemotherapy group was higher than that of the radiotherapy group although did not show a statistical difference (P > 0.05). Rational application of neoadjuvant radiochemotherapy seems to provide a modest benefit in radical resection and survival in @entity1 with locally advanced @entity418 .
