Journal of Gastrointestinal Surgery

, Volume 23, Issue 11, pp 2111–2118 | Cite as

Investigating the Survival Benefit of Combining Radiotherapy for Surgery Treated Locally Advanced Esophageal Squamous Cell Carcinoma Patients Aged 65 and Older

  • Shan HuangEmail author
  • Yuxing Li
  • Hongbing Ma
  • Wenyu Wang
  • Shuyu Zheng
  • Yue Ke
  • Fang Li
Original Article



To evaluate the survival benefit of combining radiotherapy with surgery in locally advanced esophageal squamous cell carcinoma (ESCC) patients aged over 65.


Using the SEER database, we selected patients age ≥ 65 years that were diagnosed as locally advanced ESCC during 2004–2013. Cancer-specific survival (CSS) was examined using the Kaplan–Meier analysis and compared by the log-rank test. Univariable and multivariable Cox proportional hazard models were established to identify possible prognostic factors.


A total of 972 cases were included in the study. For surgical patients aged 65–79 years, 74 patients (32.9%) were treated by surgery alone and 122 patients (54.2%) had received additional neoadjuvant radiotherapy (NRT). NRT + surgery was associated with improved CSS comparing with surgery alone (HR, 0.58; 95%CI, 0.39 to 0.85; P = 0.005). In subgroup analysis, NRT was associated with improved CSS for patients aged 65–74 years (2-year CSS 56.6% versus 39.6%, P = 0.026). No significant differences of progonosis was observed for different treatment groups in 75–79 years patients (P = 0.972).


In this SEER-based study, the addition of neoadjuvant radiotherapy before surgery was associated with improved CSS for locally advanced ESCC patients aged 65 to 74 years.


Esophageal squamous cell carcinoma Aged 65 and older Surgery Radiotherapy Survival 


Author Contributions

Conception and design: Shan Huang.

Development of methodology: Shan Huang, Yuxing Li.

Acquisition of data: Hongbing Ma, Shuyu Zheng, Yue Ke.

Analysis and interpretation of data: Wenyu Wang, Fang Li.

Writing, review and/or revision of the manuscript: Shan Huang, Wenyu Wang.

Study supervision: Shan Huang.

All authors have revised the manuscript and approved the final version to be published.


This work was supported by the Natural Science Foundation of Shaanxi Province [grant number 2017JM8099] and the Key Project of the Second Affiliated Hospital, Xi’an Jiaotong University [grant number YJ(ZD)201705].

Compliance with Ethical Standards

The Ethics Committee of the Health Science Center of Xi’an Jiaotong University approved the study.

Conflict of Interest

The authors declare that they have no conflicts of interest.

Supplementary material

11605_2019_4200_MOESM1_ESM.docx (24 kb)
ESM 1 (DOCX 24 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  1. 1.Department of Radiation Oncology, Second Affiliated HospitalXi’an Jiaotong UniversityXi’anChina
  2. 2.Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life ScienceUniversity of HelsinkiHelsinkiFinland

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