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Postoperative Chemotherapy for Thoracic Pathological T3N0M0 Esophageal Squamous Cell Carcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

The role of postoperative chemotherapy (POCT) in pathologic T3N0M0 thoracic esophageal squamous cell carcinoma (TESCC) has not been well addressed. The purpose of this study was to investigate the impact of postoperative adjuvant chemotherapy on survival, recurrence, and toxicities in pathologic T3N0M0 TESCC.

Methods

This study included 582 patients with pT3N0M0 TESCC who were treated at Sichuan Cancer Hospital from January 2009 to December 2017. The patients were divided into two groups: surgery plus postoperative chemotherapy group (S + POCT), and surgery group (S group). Propensity score matching was used to create patient groups that were balanced across several covariates (n = 236 in each group). Outcome measures included overall survival (OS) and disease-free survival (DFS).

Results

After PSM, both groups have balance factors. S + POCT have significantly improved the 5-year OS and DFS (OS, 70.8% vs. 52.8%, p <0.0001; DFS, 66.5% vs. 50.2%, p < 0.0001). Multivariate Cox analyses in the matched samples revealed that S + POCT were independently associated with longer OS (hazard ratio (HR) = 0.56, 95% confidence index (CI) 0.41–0.77, p < 0.0001) and longer DFS (HR = 0.60, 95% CI 0.45–0.82, p = 0.001) than surgery alone. Subgroup analyses showed that prognostic effect of POCT was significantly influenced by the number of resected lymph node (≤ 20) and pStage IIB but not influenced by the number of node > 20 and pStage IIA.

Conclusions

Postoperative adjuvant chemotherapy is strongly associated with improved OS and DFS in patients with pT3N0M0 TESCC. A multicenter, randomized, phase III clinical trial is warranted to confirm these findings.

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Acknowledgement

This work was supported by grants from Sichuan science and technology department key research and development Project Fund [2019YFS0378, 2018JY0277], Wu Jieping Medical Foundation, Grant/Award Number: 320.6750.17237. Cancer Research Foundation of China Anti-Cancer Association for Young Scientists (Grant No. CAYC18A33). New service model of tumor radiotherapy based on “Internet+”: the systemic development and application research of “Precision cloud radiotherapy.” Project Number: 2017YFC0113100.

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Author notes

  1. Qifeng Wang and Lin Peng have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China

    Qifeng Wang MD, Tao Li MD, Yi Wang MD, Lei Wu MD & Jinyi Lang PhD

  2. Department of Medical Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China

    Qifeng Wang MD, Tao Li MD, Bangrong Cao MD & Jinyi Lang PhD

  3. Department of Thoracic Surgery, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China

    Lin Peng MD, Wei Dai MD, Yinchun Jiang MD, Tianpeng Xie MD, Qiang Fang MD & Yongtao Han MD

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  1. Qifeng Wang MD
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Corresponding authors

Correspondence to Tao Li MD or Yongtao Han MD.

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The authors declare no actual or potential financial conflicts of interest.

Informed Consent

All patients included in this study gave their informed consents before treatment in accordance with the Declaration of Helsinki. The informed consents were also approved by the respected Ethics Committees of Sichuan Cancer Hospital.

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Wang, Q., Peng, L., Li, T. et al. Postoperative Chemotherapy for Thoracic Pathological T3N0M0 Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 27, 1488–1495 (2020). https://doi.org/10.1245/s10434-019-08112-1

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