Surgery after induction chemoradiotherapy for oesophageal cancer

Aim: We discuss the role of surgery after induction chemoradiotherapy, when a complete response is apparent. Methods: We enrolled 247 consecutive patients who underwent chemoradiotherapy and oesophagectomy for cancer. Patients were classified in two groups as to whether they had chemoradiotherapy (n=60) or not (n=187) before surgery. Results: The 5-year survival rate of patients with complete response was 54% and was significantly higher than that of the other group (P=0.018). Of the 60 patients responding, 34 (56.7%) were found to have a complete pathological tumour response (pT0). The overall sensitivity and specificity of the post-chemoradiotherapy restaging were 60.7% and 86.4%. Conclusions: Complete response after induction chemoradiotherapy is not a reliable tool in the management of oesophageal cancer. We need to improve postchemoradiotherapy restaging to be sure that chemoradiotherapy will provide the same long-term survival rates as surgery.