Author:
Wang Qifeng,Lang Jinyi,Li Tao,Peng Lin,Dai Wei,Jiang Yinchun,Xie Tianpeng,Fang Qiang,Wang Yi,Wu Lei,Cao Bangrong,Han Yongtao
Abstract
Abstract
Background and purpose
After esophagectomy, adjuvant chemotherapy (S + CT) and adjuvant chemoradiotherapy (S + CRT) can improve survival in patients with node-positive resectable esophageal cancer. However, we are not aware of any studies that directly compared these adjuvant treatments. This study aimed to compare S + CT and S + CRT for patients with esophageal cancer.
Materials and methods
We retrospectively identified patients with node-positive esophageal squamous cell carcinoma who underwent S + CT or S + CRT at Sichuan Cancer Hospital during 2008–2017. The patients’ characteristics were compared, as well as their overall survival (OS) and disease-free survival (DFS) outcomes. Propensity score matching was used to create balanced patient groups according to adjuvant treatment, and a Cox proportional hazards model was used to identify factors that predicted the survival outcomes.
Results
The 859 eligible patients underwent S + CRT (250 patients, 29.1%) or S + CT (609 patients, 70.9%). After propensity score matching (247 patients per group), the 5-year OS rates were 41.8% for S + CRT and 26.8% for S + CT (p = 0.028), and the 5-year DFS rates were 37.2% for S + CRT and 25.5% for S + CT (p = 0.012). Multivariate Cox regression analysis of the matched samples revealed that, relative to the S + CT group, the S + CRT group had better OS (hazard ratio: 0.71, 95% CI: 0.56–0.91; p = 0.006) and DFS (hazard ratio: 0.70, 95% CI: 0.56–0.88; p = 0.002).
Conclusion
Among patients with node-positive resectable esophageal squamous cell carcinoma, S + CRT was associated with better OS than S + CT. A multicenter randomized clinical trial is warranted to confirm these findings.
Funder
Sichuan Province Science and Technology Support Program
Publisher
Springer Science and Business Media LLC
Subject
Radiology Nuclear Medicine and imaging,Oncology
Cited by
6 articles.
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