Postoperative adjuvant chemotherapy for operable esophageal cancer: a pilot clinical study.

Thirty-eight patients with node positive squamous cell carcinoma of the esophagus were entered into a pilot clinical study using postoperative adjuvant chemotherapy (cisplatinum 100 mg/m2 and methotrexate 150 mg/m2 x 4 cycles) with an intent of improving cure rates and overall survival. Patient compliance was excellent and toxicity minimal. At 24 months of follow-up 22 patients (58%) were disease free, while 14 patients (37%) have relapsed and 2 were lost to follow-up. A highly significant correlation was noted between the number of nodes involved, the grade of the tumour, and the response to chemotherapy. Patients with poorly differentiated tumours and those with more than 4 nodes involved were more likely to develop recurrent disease (P less than 0.01 and P less than 0.005). We conclude that postoperative chemotherapy following resection for carcinoma of the esophagus is well tolerated with minimal side effects. It may also have an impact on improving disease free and overall survival.