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Comment & Response
September 22, 2021

Selection of Neoadjuvant Treatment Arms in Trials of Patients With Squamous Cell Cancer of the Esophagus

Author Affiliations
  • 1Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri
  • 2Division of Oncology, Department of Medicine, Washington University Medical School, St Louis, Missouri
JAMA Surg. 2022;157(1):83-84. doi:10.1001/jamasurg.2021.4532

To the Editor We read with interest the article by Wang et al1 in JAMA Surgery. We congratulate the authors on undertaking a large, randomized study in a unique population; however, we wanted to bring up some concerns regarding the study rationale and results.

First, the authors examined the morbidity and mortality of minimally invasive esophagectomy (MIE) after 2 neoadjuvant approaches in patients with esophageal squamous cell cancer (ESCC). They argue that both neoadjuvant chemotherapy and chemoradiation are reasonable preoperative options because the optimal regimen is not fully established. They defend this by stating that (1) only 3 trials have directly compared chemoradiation with chemotherapy and were mainly including patients with adenocarcinoma and (2) none were specifically done with MIE.

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