A propensity-score matching analysis comparing long-term survival of surgery alone and postoperative treatment for patients in node positive or stage III esophageal squamous cell carcinoma after R0 esophagectomy

被引：17

作者：

Yu, Shufei ^{[1
,2
,3
]}

Zhang, Wencheng ^{[4
]}

Ni, Wenjie ^{[1
,2
]}

Xiao, Zefen ^{[1
,2
]}

Wang, Qifeng ^{[5
]}

Zhou, Zongmei ^{[1
,2
]}

Feng, Qinfu ^{[1
,2
]}

Zhang, Hongxing ^{[1
,2
]}

Chen, Dongfu ^{[1
,2
]}

Liang, Jun ^{[1
,2
]}

Lv, Jima ^{[1
,2
]}

Hui, Zhouguang ^{[1
,2
]}

He, Jie ^{[2
,6
]}

Gao, Shugeng ^{[2
,6
]}

Sun, Kelin ^{[2
,6
]}

Fang, Dekang ^{[2
,6
]}

Liu, Xiangyang ^{[2
,6
]}

Li, Yexiong ^{[1
,2
]}

机构：

[1] Chinese Acad Med Sci, Dept Radiat Oncol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, 17 Panjiayuannanli Rd, Beijing, Peoples R China

[2] Peking Union Med Coll, 17 Panjiayuannanli Rd, Beijing, Peoples R China

[3] Beijing Chao Yang Hosp, Dept Oncol Radiat Oncol, Beijing, Peoples R China

[4] Tianjing Med Univ, Natl Clin Res Ctr Canc, Dept Radiat Oncol, Canc Inst & Hosp, Tianjin, Peoples R China

[5] Sichuan Canc Hosp, Dept Radiat Oncol, Chengdu, Sichuan, Peoples R China

[6] Chinese Acad Med Sci, Natl Clin Res Ctr Canc, Canc Hosp, Dept Thorac Surg,Natl Canc Ctr, Beijing, Peoples R China

来源：

RADIOTHERAPY AND ONCOLOGY | 2019年 / 140卷

基金：

中国国家自然科学基金;

关键词：

Propensity score matching; Esophageal carcinoma; R0; surgery; Radiotherapy; Chemoradiation; RADIOTHERAPY IMPROVED SURVIVAL; RADIATION-THERAPY; CHEMORADIATION THERAPY; CURATIVE RESECTION; CANCER-PATIENTS; NUMBER; CHEMORADIOTHERAPY; CHEMOTHERAPY; UNION;

D O I：

10.1016/j.radonc.2019.06.020

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Surveillance was recommended for patients after R0 esophagectomy by National Comprehensive Cancer Network (NCCN) guidelines. However, local failure was high in locally advanced patients (48-78%). The present study aimed to determine whether adjuvant treatment improved survival for stage IIb-III thoracic esophageal squamous cell carcinoma (TESCC). Methods: A retrospective review of patients diagnosed as esophageal carcinoma at the Chinese Academy of Medical Sciences Cancer hospital, between January 2004 and December 2011, was performed. A database compiling 975 patents with node positive or stage III thoracic esophageal carcinoma after R0 surgery with or without postoperative radiation/chemoradiation was created. A 1:1 matched study group was generated by the Greedy method after propensity score matching (PSM) analysis. Survival curves were calculated by the Kaplan-Meier method and compared with the log-rank test. Univariate and multivariate analyses were using the Cox proportional hazards regression model. Results: 975 patients were enrolled in the study, 510 patients (52.3%) did not receive any postoperative treatment after R0 surgery and 465 patients had either postoperative chemoradiation or radiotherapy. Median follow-up was 69.2 months. After PSM, 222 well-balanced patients in each group demonstrated the same results. The 3-year, 5-year survival rates and median survival in surgery group (33.0%, 26.4%, 24.3 months) were inferior to those in postoperative treatment group (48.3%, 37.1% and 34.3 months), (P = 0.002). Compared with radiotherapy, postoperative chemoradiation did not improve DFS and OS (P = 0.692; P = 0.368). N stage and adjuvant treatment are independent prognostic factors. Conclusions: Adjuvant treatment could improve survival for patients with stage IIb-III TESCC. (C) 2019 Published by Elsevier B.V.

引用

页码：159 / 166

页数：8

共 41 条

[41] Effects of plasma concentrations of 5-fluorouracil on long-term survival after treatment with a definitive 5-fluorouracil/cisplatin-based chemoradiotherapy in Japanese patients with esophageal squamous cell carcinoma
Kuwahara, Akiko
Yamamori, Motohiro
Kadoyama, Kaori
Nishiguchi, Kohshi
Nakamura, Tsutomu
Miki, Ikuya
Tamura, Takao
Okuno, Tatsuya
Omatsu, Hideaki
Sakaeda, Toshiyuki
JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH, 2011, 30

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