Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients

To evaluate the effect of surgical resection on the outcome of patients with clinical Stage II or III cancer of the esophagus treated with concurrent chemoradiotherapy. A retrospective review of 132 consecutive patients with clinical Stage II or III esophageal cancer treated with concurrent chemoradiotherapy between January 1990 and December 1998 was performed. Of the 132 patients, 60 underwent esophagectomy 6–8 weeks after chemoradiotherapy. The median radiation dose was 50 Gy (range, 30–64.8 Gy) in the definitive chemoradiation group and 45 Gy (range, 30–50.4 Gy) in the chemoradiation plus esophagectomy group. Statistically significant differences were found between the two groups in median age, histologic subtype, tumor location, and number of patients with T4 disease. Patients who underwent definitive chemoradiotherapy were older ( p = 0.0004) and more likely to have squamous cell carcinoma than adenocarcinoma ( p