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Table 2 Randomized trials of preoperative radiotherapy (RT) and surgery versus surgery alone.

From: Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis

Study, year [Reference] Participants Number of patients Interventions Median Survival (Months) Survival Rate (%) Adverse Effects (Number of Patients)
      1 yr 2 yr 3 yr 4 yr 5 yr  
Launois et al. 1981 [21] 124 patients March 1973-June 1976 France, single centre, squamous cell 67 64 – 90 Gy preop RT + esophagectomy 4.5 46 20 15 14 10 perioperative mortality was 23% in both groups.
   versus versus versus versus  
   57 esophagectomy (left thoracotomy) 8.2 (mean) 50 35 25 20 12  
      p = NS, but NR  
Gignoux et al. 1987 [22] 229 patients [dates not reported] EORTC, 8 centres, squamous cell, no cervical lesions, no previous cancer, no previous treatment. 115 33 Gy preop RT + esophagectomy 12.3 55 24 20 17 10 tracheosophageal fistula, 2; bleeding, 1; esophagitis, 1; respiratory deaths, 6
   versus versus versus versus versus
   114 esophagectomy 12 (mean) 57 30 14 11 9 respiratory deaths, 8
      No difference in survival (p = 0.94), but RT may delay local recurrence  
Wang et al. 1989 [23] 206 patients June 1977-May 1985 China, single centre histology not reported < 65 years age, < 8 cm length no metastases 104 40 Gy preop RT + esophagectomy NR - - - - 35 leaks, 1; perioperative deaths, 5
   versus versus versus versus versus
   102 esophagectomy NR - - - - 30 leaks, 5; perioperative deaths, 5
      No difference in survival (p > 0.05).  
Nygaard* 1992 [24] 108 patients Jan 1983-Jan 1988 Scandinavia, multi centre squamous cell < 75 years of age, Karnofsky score > 50, T1, T2, Nx, M0 > 21 cm from incisors 58 35 Gy preop RT + esophagectomy 10 44 25 21 - - respiratory, 5; leaks, 2; postoperative deaths, 4
   versus versus versus versus versus
   50 esophagectomy 7 34 13 9 - - respiratory, 5; leaks, 2; postoperative deaths, 5
      No difference in survival (p = 0.08).  
Arnott 1992 [25] 176 patients 1979–1983 Scotland, single centre < 80 years, squamous cell adenocarcinoma, distal 2/3 esophagus 90 20 Gy preop RT + esophagectomy 8 40 22 13 9 9 respiratory, 10; postoperative deaths, 10
   versus versus versus versus versus
   86 esophagectomy (left thoracoabdominal) 8 40 28 23 21 17 respiratory, 5; postoperative deaths, 8; surgical, 2
      No difference in survival (p = 0.40).  
Fok* 1994 [5] 79 patients 1968–1981 Hong Kong, single centre Squamous cell, middle 1/3 esophagus 40 24–53 Gy preop RT + esophagectomy 11 42 34 24 10 10 respiratory, 20; postoperative deaths, 12; leaks 11
   versus versus versus versus versus
   39 esophagectomy (right thoracotomy, left neck, and abdomen) 22 58 36 24 16 16 respiratory, 15; postoperative deaths, 3; leaks, 7
      No difference in survival.  
  1. *Patients randomized to four groups; data shown are for radiotherapy + surgery versus surgery alone.
  2. Note: EORTC, European Organization for Research and Treatment of Cancer.