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Recent studies in esophageal and gastric cancer report survival benefits both for preoperative chemotherapy followed by surgery (JW Oncol Hematol Oct 16 2006) and for preoperative chemoradiotherapy followed by surgery (Lancet Oncol 2007; 8:226). To compare the efficacy of these two multimodal treatment approaches, German investigators performed a multicenter phase III trial involving untreated patients (age, ≤70) with high-risk T3–T4 cancers of the distal esophagus, esophagogastric junction, or gastric cardia, as determined by endoscopic ultrasound, laparoscopy, or computed tomography scan. Because of a slow recruitment rate, only 126 of a planned 354 patients were enrolled.
A total of 119 evaluable patients were randomized to two treatment …