Abstract
Background
For patients with locoregional esophageal squamous cell carcinoma (ESCC), survival outcomes among neoadjuvant chemoradiotherapy followed by operation (nCRT-OP), definitive chemoradiotherapy (dCRT), and esophagectomy alone remain controversial.
Patients and methods
Information from the 2008–2016 Taiwan Cancer Registry was used. A total of 7637 cT1b–4, N0/+, M0 ESCC patients receiving nCRT-OP (n = 1955), dCRT (n = 4122), or esophagectomy alone (n = 1560) were included. Propensity score matching was performed to balance clinical variables among the three groups. Stage-specific overall survival was compared before and after propensity score matching. Univariable and multivariable analyses were performed to identify prognostic factors.
Results
Propensity score matching resulted in 1407 cases for comparison. The 5-year overall survival rates for matched patients treated via dCRT, nCRT-OP, and esophagectomy alone were 19.77%, 31.23%, and 30.52%, respectively (p < 0.001). On multivariable analysis, treatment modality was still an independent prognostic factor both before and after propensity score matching. nCRT-OP and esophagectomy alone were associated with significantly better overall survival than dCRT for locoregional ESCC patients.
Conclusions
This propensity-matched study revealed that nCRT-OP and esophagectomy provided better survival than dCRT in cT1b–4, N0/+, M0 ESCC patients.
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Bing-Yen Wang and Hui-Shan Chen designed the study. Bing-Yen Wang wrote the manuscript. Ching-Hsiung Lin and Shiao-Chi Wu analyzed the data.
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Drs. Bing-Yen Wang, Hui-Shan Chen, Shiao-Chi Wu, Heng-Chung Chen, Wei-Heng Hung, and Ching-Hsiung Lin have no conflicts of interest or financial ties to disclose.
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Chen, HS., Lin, CH., Wu, SC. et al. Survival Comparison Among Neoadjuvant Chemoradiotherapy Followed by Esophagectomy, Definitive Chemoradiotherapy, and Esophagectomy Alone for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 29, 3617–3627 (2022). https://doi.org/10.1245/s10434-021-11210-8
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DOI: https://doi.org/10.1245/s10434-021-11210-8