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Problems in neoadjuvant chemoradiotherapy preceding surgery for advanced squamous cell carcinoma of the thoracic esophagus

  • Kaoru Ishida
  • Keisuke Koeda
  • Nobuhiro Sato
  • Kenichiro Ikeda
  • Koki Ohtsuka
  • Kiichi Aoki
  • Yusuke Kimura
  • Takeshi Iwaya
  • Noriyuki Uesugi
  • Ryuji Nakamura
Original Article

Abstract

The adverse effect of neoadjuvant chemoradiotherapy on the postoperative course in esophageal cancer was studied in 9 patients undergoing neoadjuvant chemoradiotherapy preceding surgery for thoracic esophageal carcinoma possibly involving adjacent organs (neoadjuvant group), and 13 patients undergoing surgery without neoadjuvant therapy for same disease (control group). The two groups were compared for volume of intraoperative hemorrhage, surgical duration, frequency of postoperative morbidity, and for postoperative changes in blood platelet counts, and serum thrombopoietin and interleukin-6 levels. Mean intraoperative blood loss was 1121 g (580–1,662 g) in the neoadjuvant group and 546.5 g (274.7–778.3 g) in controls group (Student’s T test: p < 0.01). No significant difference was seen found between the two groups in the degree of postoperative deterioration in cardiopulmonary function or in interleukin-6 levels. Blood platelet counts decreased in both groups until postoperative day 7, but recovery on postoperative day 14 was significantly depressed in the neoadjuvant group compared to controls. Serum thrombopoietin levels were higher in the neoadjuvant group than in controls (Mann-Whitney U-test: p < 0.05). We found that neoadjuvant chemoradiotherapy induces latent postoperative myelosuppression and may lead to intractable infection.

Index words

esophageal cancer chemoradiotherapy neoadjuvant therapy 

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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 1999

Authors and Affiliations

  • Kaoru Ishida
    • 1
    • 2
    • 3
    • 4
  • Keisuke Koeda
    • 1
    • 2
    • 3
    • 4
  • Nobuhiro Sato
    • 1
    • 2
    • 3
    • 4
  • Kenichiro Ikeda
    • 1
    • 2
    • 3
    • 4
  • Koki Ohtsuka
    • 1
    • 2
    • 3
    • 4
  • Kiichi Aoki
    • 1
    • 2
    • 3
    • 4
  • Yusuke Kimura
    • 1
    • 2
    • 3
    • 4
  • Takeshi Iwaya
    • 1
    • 2
    • 3
    • 4
  • Noriyuki Uesugi
    • 1
    • 2
    • 3
    • 4
  • Ryuji Nakamura
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of Surgery 1School of Medicine, Iwate Medical UniversityMoriokaJapan
  2. 2.Department of Pathology 2School of Medicine, Iwate Medical UniversityMoriokaJapan
  3. 3.Department of Clinical PathologySchool of Medicine, Iwate Medical UniversityMoriokaJapan
  4. 4.Department of RadiologySchool of Medicine, Iwate Medical UniversityMoriokaJapan

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