Summary
42 patients with localized squamous cell carcinoma of the esophagus were treated according to a phase II study with cisplatin, vindesine and bleomycin (KelsenSchema) prior to surgery. In 18 of these patients partial remission was achieved and in two cases complete remission. Of the 40 patients which were presented to surgical treatment, 4 were inoperable, in 22 cases the tumor was removed in a potentially curative manner and in 14 patients a palliative resection was performed. The postoperative mortality was 4 of 36 resected patients. Anastomotic leakage was found in 5 patients and severe cardiopulmonary complications in 4 patients. The side effects of the preoperative treatment were acceptable and seem justified by the high resectability rate and the significant improvement in survival of patients who responded to chemotherapy.
Zusammenfassung
42 Patienten mit nicht fernmetastasiertem Plattenepithel-Carcinom des Oesophagus wurden präoperativ cytostatisch vorbehandelt (Kelsen-Schema). Bei 18 Patienten kam es zu einer partiellen, bei 2 Patienten zu einer vollständigen Tumorremission. Von 40 Patienten, die sich einem operativen Eingriff unterzogen, waren 4 inoperabel. Bei 14 Patienten konnte der Tumor palliativ und bei 22 potentiell kurativ entfernt werden. Postoperativ verstarben 4 der 36 resezierten Patienten. Eine Anastomoseninsuffizienz trat bei 5 Patienten und schwere kardio-pulmonale Komplikationen bei 4 Patienten postoperativ auf. Die Nebenwirkungen der präoperativen Behandlung waren akzeptabel und werden durch das Ergebnis der Behandlung mit einer hohen Resektabilitätsrate und einer Verbesserung der Überlebenszeit von Patienten, die auf die präoperative Chemotherapie ansprechen, gerechtfertigt.
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Schlag, P., Herrmann, R., Raeth, U. et al. 23. Präoperative Chemotherapie beim Oesophagus-Carcinom: Vorteile oder Gefahr für den chirurgischen Eingriff?. Langenbecks Arch Chiv 372, 155–160 (1987). https://doi.org/10.1007/BF01297807
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DOI: https://doi.org/10.1007/BF01297807