Endoscopic therapy versus esophagectomy for T1bN0M0 esophageal cancer: A population-based study using propensity score matching

被引：3

作者：

Zhu, Jiamin ^{[1
]}

Liang, Xiao ^{[1
]}

Chen, Shusen ^{[2
]}

Qin, Ya ^{[1
]}

Shen, Dong ^{[1
]}

Yang, Xi ^{[3
]}

机构：

[1] Southeast Univ, Dept Oncol, Med Coll, Affiliated Jiangyin Hosp, 163 Shoushan Rd, Jiangyin 214400, Peoples R China

[2] Nantong Univ, Affiliated Tumor Hosp, Nantong Tumor Hosp, Dept Radiat Oncol, Nantong 226321, Peoples R China

[3] Fudan Univ, Shanghai Canc Ctr, Shanghai Clin Res Ctr Radiat Oncol, Shanghai Med Coll,Dept Radiat Oncol,Dept Oncol,Sha, Shanghai 200032, Peoples R China

来源：

HELIYON | 2023年 / 9卷 / 11期

关键词：

Endoscopic therapy; Esophageal cancer; Esophagectomy; Chemoradiotherapy; BARRETTS-ESOPHAGUS; MUCOSAL RESECTION; ADENOCARCINOMA; PREDICTORS; DIAGNOSIS;

D O I：

10.1016/j.heliyon.2023.e22189

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: Endoscopic therapy is an optional strategy for the treatment of esophageal cancer (EC) under an early stage, especially stage T1a. However, its efficacy in the treatment of T1b EC has not been thoroughly assessed. We investigated the efficacy of esophagectomy, endoscopic therapy, as well as chemoradiotherapy in patients with T1bN0M0 EC. Methods: The Surveillance, Epidemiology, and End Results database (SEER) was employed to identify patients diagnosed with T1bN0M0 EC. Patient demographics were compared among the endoscopic therapy, esophagectomy, and chemoradiotherapy groups. Our study employed Kaplan-Meier analysis and Cox regression model to evaluate patient outcomes and long-term survival rates. The overall survival (OS) and cancer-specific survival (CSS) rates were compared among patients with EC who underwent endoscopic therapy or esophagectomy, employing propensity score matching (PSM). Results: A total of 820 patients diagnosed with T1bN0M0 EC were identified. The number of patients who received endoscopic therapy, esophagectomy, and chemoradiotherapy was 173, 556, and 91, respectively. Patients subjected to endoscopic therapy and esophagectomy had greatly longer OS and CSS than those who underwent chemoradiotherapy. Patients treated with esophagectomy had longer OS than endoscopic therapy patients, but there were no differences in CSS between the two groups. PSM generated 153 patient pairs among T1bN0M0 patients, demonstrating that both the esophagectomy and endoscopic therapy groups exhibited comparable OS and CSS rates. Conclusion: Endoscopic therapy and esophagectomy were associated with a significant survival advantage compared with chemoradiotherapy in patients with T1bN0M0 EC. In contrast, after PSM, among the EC patients with stage T1bN0M0, OS and CSS did not differ after endoscopic therapy or esophagectomy. These results indicate that endoscopic therapy could be a viable alternative to esophagectomy in patients diagnosed with T1bN0M0 EC.

引用

页数：10