Preoperative Chemoradiation Therapy Versus Chemotherapy in Patients Undergoing Modified En Bloc Esophagectomy for Locally Advanced Esophageal Adenocarcinoma: Is Radiotherapy Beneficial?

Whether adding radiotherapy to induction chemotherapy prior to esophagectomy adds a survival benefit is uncertain.  The authors assessed outcomes of 214 patients with T3N1M0 adenocarcinoma among three institutions who underwent induction therapy followed by esophagectomy.   114 patients had chemotherapy and 100 patients had chemoradiotherapy.  90-day mortality did not differ between the groups (5.3% vs 4.0%), and median survival between the groups was similar (31.2 vs 39.2 months).  The role of radiotherapy as part of induction therapy for management of adenocarcinoma of the esophagus requires further exploration.