Esophageal cancer survival rates increase
Giving patients chemotherapy and radiotherapy in combination with surgery saves lives
The survival rate of esophageal cancer patients with a tumor that can be surgically removed increases by 33 percent if they undergo chemotherapy and radiotherapy prior to surgery. This is the result of a large Dutch study carried out by five academic institutions and two hospitals, led by Erasmus MC. The researchers have published their findings in the leading scientific journal The New England Journal of Medicine (NEJM). The discovery is important as the number of people diagnosed with esophageal cancer is increasing substantially.
Every year, 480,000 new cases of esophageal cancer are diagnosed worldwide. More than half of the patients diagnosed with esophageal cancer are not eligible for surgery because of the extent of the disease or metastases. Five-year survival rate of patients who can undergo surgery is approximately 40 percent. The study shows that this percentage increases by 13 percent if the patients are treated with a combination of chemotherapy and radiotherapy before surgery. Among the patients who only underwent surgery, 50 percent was still alive after two years. Half of the patients who had received the extensive treatment were still alive after more than four years.
Pieter van Hagen of the Surgery department and Ate van der Gaast of the Internal Oncology department, first and last author, respectively, of this article, are pleased with the outcomes of this study: “It is difficult to remove a tumor in the area around the esophagus completely by surgery. The esophagus is surrounded by many vital organs that must not be damaged. This results in tumor cells often being left behind after surgery. Chemotherapy and radiotherapy substantially reduce the chance of tumor cells being left behind after surgery. The treatment with chemotherapy and radiotherapy was so effective that in 29 percent of the patients no tumor cells were found after treatment.”
Every year more people undergo surgery for esophageal cancer. It is expected that there will a substantial increase over the coming years, not only because of the aging population but most likely also as a result of less healthy lifestyles, overweight and esophageal irritation because of refluxed stomach content. The researchers are very satisfied with the collaboration with the other institutions and proud of the fact that for the past two years the majority of all esophageal cancer patients in the Netherlands have been treated with chemotherapy and radiotherapy prior to surgery. “Because the first results were very promising, we started treating patients in this way even before the last analyses were completed. As a result, the treatment of esophageal cancer patients has improved substantially”. This study is another example of the fact that important studies are feasible in the Netherlands thanks to close cooperation.
For the study, the survival rates of 366 patients were compared from March 2004 to December2008. The research was carried out by Erasmus MC in cooperation with AMC, VU MC, UMC St. Radboud, UMC Groningen, Catharina Hospital in Eindhoven and Rijnstate Hospital in Arnhem. Funds for the research were provided by the Dutch Cancer Foundation (KWF Kankerbestrijding).
Erasmus MC is the largest and most authoritative scientific University Medical Center in the Netherlands. Almost 13,000 staff members work within the core tasks of patient care, education, and scientific research on the continuous improvement and enforcement of individual patient care and social healthcare. They develop high-level knowledge, pass this on to future professionals, and apply it in everyday patient care. Over the next five years, Erasmus MC wants to grow into one of the best medical institutes in the world. Erasmus MC is part of the Dutch Federation of University Medical Centers (NFU): www.nfu.nl.