The Effect of Neoadjuvant Therapy on Early Complications of Esophageal Cancer Surgery

Introduction: Early diagnosis and appropriate treatment is required in esophageal cancer due to its invasive nature. The aim of this study was to evaluate early post-esophagectomy complications in patients with esophageal cancer who received neoadjuvant chemoradiotherapy (NACR).   Materials and Methods: This randomized clinical trial was carried out between ۲۰۰۹ and ۲۰۱۱. Patients with lower-third esophageal cancer were randomly assigned to one of two groups. The first group consisted of ۵۰ patients receiving standard chemoradiotherapy (Group A) and then undergoing surgery, and the second group consisted of ۵۰ patients undergoing surgery only (Group B). Patients were evaluated with respect to age, gender, clinical symptoms, type of pathology, time of surgery, perioperative blood loss, and number of lymph nodes resected as well as early post-operative complicate including leakage at the anastomosis site, chylothorax and pulmonary complications, hospitalization period, and mortality rate within the first ۳۰ days after surgery.   Results: The mean age of patients was ۵۵ years. Seventy-two patients had squamous cell carcinoma (SCC) and ۲۸ patients had adenocarcinoma (ACC). There was no significant difference between the two groups with respect to age, gender, time of surgery, complications including anastomotic leakage, chylothorax, pulmonary complications, cardiac complications, deep venous thrombosis (DVT), or mortality. However, there was a significant difference between the two groups regarding hospital stay, time of surgery, perioperative blood loss, and number of lymph nodes resected.   Conclusion:  The use of NACR did not increase early post-operative complications or mortality among patients with esophageal cancer. 

Keywords:

Esophageal Cancer , Neoadjuvant Therapy , Surgery