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Survival Comparison Among Neoadjuvant Chemoradiotherapy Followed by Esophagectomy, Definitive Chemoradiotherapy, and Esophagectomy Alone for Esophageal Squamous Cell Carcinoma

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

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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Author information

Author notes

  1. Hui-Shan Chen and Ching-Hsiung Lin have contributed equally to this work, and each should be accorded first authorship.

Authors and Affiliations

  1. Department of Health Care Administration, Chang Jung Christian University, Kaohsiung, Taiwan

    Hui-Shan Chen PhD

  2. Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan

    Ching-Hsiung Lin MD, PhD & Bing-Yen Wang MD, PhD

  3. Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Kaohsiung, Taiwan

    Ching-Hsiung Lin MD, PhD

  4. Department of Recreation and Holistic Wellness, MingDao University, Changhua, Taiwan

    Ching-Hsiung Lin MD, PhD

  5. Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Shiao-Chi Wu PhD

  6. Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua City, Changhua County, Taiwan

    Bing-Yen Wang MD, PhD

  7. School of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Bing-Yen Wang MD, PhD

  8. School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Bing-Yen Wang MD, PhD

  9. College of Medicine, National Chung Hsing University, Taichung, Taiwan

    Bing-Yen Wang MD, PhD

  10. Center for General Education, Ming Dao University, Changhua, Taiwan

    Bing-Yen Wang MD, PhD

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  1. Hui-Shan Chen PhD
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Contributions

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.

Corresponding author

Correspondence to Bing-Yen Wang MD, PhD.

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Disclosures

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

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