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Lessons Learned: Two courses of neoadjuvant therapy using S-1 plus cisplatin for clinical stage III esophageal squamous cell carcinoma did not achieve expected response rate according to endoscopic evaluation of primary tumors. Subsequent esophagectomy was safely performed., Background: In Japan, esophagectomy after two courses of 5-fluorouracil plus cisplatin is regarded a standard strategy for treating stage II or III esophageal squamous cell carcinoma (ESCC). However, 5-fluorouracil plus cisplatin does not benefit cohorts with clinical stage III ESCC, suggesting the need for a more effective regimen., Methods: A single-arm, open-label phase II trial was conducted to evaluate the safety and efficacy of two courses of neoadjuvant chemotherapy using S-1 plus cisplatin (NAC-SP) for clinical stage III ESCC. The primary endpoint was overall response rate as defined by endoscopic evaluation of primary tumors., Results: We enrolled 26 patients. The completion rate for the two courses of NAC-SP was 61.5%. Grade 3 or higher adverse events were experienced by 38.4% of patients. The treatment response rate according to endoscopic findings, acquired before the second course, was 34.6% and below the expected level (55.0%). The morbidity rate of patients who underwent radical subtotal esophagectomy (96.2%) was 32.0%. Repeat surgery was unnecessary, and surgery-associated deaths did not occur. The 5-year progression-free survival (PFS) and overall survival (OS) rates were 84.6% and 92.2%, respectively., Conclusion: We demonstrate safety of NAC-SP, but not its efficacy, for patients with clinical stage III ESCC. Subsequent esophagectomy was safely performed., (© AlphaMed Press; the data published online to support this summary are the property of the authors.)

Background/aims: The objective of this study was to evaluate the efficacy and safety of landiolol hydrochloride, a newly developed ultra-short-acting β1-selective blocker, for postoperative tachyarrhythmia after esophagectomy., Methodology: In total 231 patients underwent transthoracic esophagectomy at the Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine from 2007 to 2012. Twenty-four patients who were treated with either landiolol hydrochloride (n = 11) or conventional agents (combination of calcium channel blocker and digitalis preparation; control group, n = 13) for postoperative tachyarrhythmia after transthoracic esophagectomy were retrospectively analyzed. Tachyarrhythmia was defined as a heart rate of >120 bpm or atrial fibrillation. Hemodynamic changes, conversion rates, and adverse events were evaluated., Results: The reduction in the heart rate at 1 h after medication was seen significantly more frequent in the landiolol group than in the control group. The time to conversion to sinus rhythm was also significantly shorter in the landiolol group. There were no significant differences between the two groups in blood pressure either before or after the medication. One patient in the landiolol group showed hypotension and bradycardia, without serious consequences., Conclusions: Landiolol hydrochloride can be effectively and safely used in patients who develop tachyarrhythmia after esophagectomy.