Chemotherapy before and after surgery may be new standard treatment for some patients with oesophageal cancer

Prof Jens Hoeppner - University of Bielefeld, Bielefeld, Germany

We have done research on multimodality treatment of oesophageal adenocarcinoma. We carried out the ESOPEC trial. ESOPEC was a comparison in patients with locally advanced resectable oesophageal carcinoma between two treatment regimens. The one was perioperative chemoradiation following surgery, the other one was perioperative chemotherapy as a sandwich from surgery.

We did a prospective randomised trial with a 1:1 comparison and we found out that perioperative chemotherapy with the FLOT protocol is superior in the endpoint of overall survival compared to neoadjuvant chemoradiation.

It will have major impact on practice in many countries, especially the UK and maybe the Netherlands as both regimens so far have been judged as equal. But our trial now found out that they are not equal, patients after receiving perioperative chemotherapy and surgery have a significant amount of added lifetime, they have a 30% lesser risk of dying within the first three years.