Article Text


Oesophageal I
PTU-165 Endoscopic response of oesophageal carcinoma to neo-adjuvant chemotherapy and survival post-oesophagectomy
  1. A M Jones,
  2. J Cornish,
  3. D Chan,
  4. G Clark
  1. Upper Gastrointestinal Surgery, University Hospital of Wales, Cardiff, UK


Introduction Endoscopy and biopsy is an essential initial investigation in oesophageal carcinoma. At our unit a repeat endoscopy is conducted after a patient has completed neo-adjuvant chemotherapy and prior to proceeding to oesophagectomy, predominantly to obtain anatomical information. This study aims to determine whether prognostic information can be derived from the response to chemotherapy.

Methods Data were retrospectively collected for patients who had undergone oesophagectomy following neo-adjuvant chemotherapy under a single surgeon over a 10-year period. At endoscopy after chemotherapy, it was noted whether the tumour had made a complete response, a partial response or no response at all, according to length, circumferential involvement and degree of stenosis. Survival data were obtained and compared between groups.

Results 72 patients (60 Male, 12 Female) were identified. 25 patients had no response to neo-adjuvant chemotherapy as assessed endoscopically and had a median survival of 27 months and 2-year survival of 38%. 39 patients showed a partial response endoscopically and had a median survival of 30 months and a 2-year survival of 40%. For the eight patients who had a complete response median survival was 57 months and 2-year survival of 68%.

Conclusion The response to neo-adjuvant chemotherapy as assessed endoscopically is predictive of post-operative prognosis. A larger study is required to determine if endoscopic assessment could be used to select patients unlikely to benefit from surgery.

Competing interests None declared.

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