Aim We retrospectively investigated the efficacy and safety of combination chemotherapy with 5-fluorouracil (5-FU) and cisplatin plus docetaxel (DCF) as preoperative chemotherapy. Methods One hundred and seven patients were diagnosed with esophageal cancer of clinical stage II and III (except T4) from March 2007 to June 2009. Among these, five patients who had extensive locoregional lymph node metastases underwent preoperative DCF chemotherapy. Results Median age of the five patients was 59 (51-67) years, and all were men with clinical stage III esophageal cancer. The best overall responses were 80% with partial response (PR) and 20% with stable disease (SD). Histological response of grade 1b and more was also 80%. The hematologic toxicities included grade 3 leucopenia in 80% of patients; grade 3 or 4 neutropenia was observed in all patients. Febrile neutropenia occurred in 20% of patients. Nonhematologic toxicities included grade 3 anorexia in 80% of patients. The operations were not postponed due to any adverse events. Postoperative complications included pneumonia, pneumothorax, and cervical lymphatic leakage (one case each). No chemotherapy-related postoperative complications were observed. Median follow-up of surviving patients was 51.5 (33.9-56.4) months. Disease-free survival times were 12.1, 30.9, 48.0, 49.0, and 54.0 months, respectively. Overall survival times were 28.9, 33.9, 51.0, 52.1, and 56.4 months, respectively. Conclusions The response rate of preoperative DCF was 80%, and toxicities were tolerated with support therapies such as granulocyte colony-stimulating factor (G-CSF) and dexamethasone. We therefore concluded that this preoperative treatment might be a promising strategy for patients who have extensive regional lymph node metastases.
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