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Standard preoperative therapy for esophageal adenocarcinoma is combined chemoradiotherapy followed by surgery. The use of preoperative chemotherapy without radiation therapy was a failed strategy in U.S. trials, but it is advocated by some European investigators. Now, UK investigators have conducted an open-label, randomized, phase III trial (UK MRC OE05) to determine whether increasing the intensity of standard neoadjuvant chemotherapy improves survival in patients with resectable esophageal cancer.
All 897 patients underwent preoperative endoscopic ultrasound staging, CT scan imaging, and many underwent staging laparoscopy and had positron emission tomography scans. Most had T3N0-1 disease (86%–87%) and tumors involving the gastroesophagea…