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- Title
Comparison between surgery and definitive chemoradiotherapy for patients with resectable esophageal squamous cell carcinoma: a propensity score analysis.
- Authors
Nomura, Motoo; Oze, Isao; Kodaira, Takeshi; Abe, Tetsuya; Komori, Azusa; Narita, Yukiya; Masuishi, Toshiki; Taniguchi, Hiroya; Kadowaki, Shigenori; Ura, Takashi; Andoh, Masashi; Tachibana, Hiroyuki; Uemura, Norihisa; Tajika, Masahiro; Niwa, Yasumasa; Muto, Manabu; Muro, Kei
- Abstract
Purpose: Our intent was to compare survival following neoadjuvant chemotherapy followed by surgery versus chemoradiotherapy (CRT) among patients with potentially resectable esophageal squamous cell carcinoma. Methods: Information about 406 consecutive esophageal cancer patients with resectable disease who underwent surgery with neoadjuvant chemotherapy consisting of cisplatin plus 5-fluorouracil or who underwent definitive CRT was reviewed. The survival outcomes were analyzed using the Kaplan-Meier method and propensity score-adjusted Cox proportional hazards models. Relevant variables were included in the propensity score model. Results: Overall, 206 patients planned to undergo surgery (S group) and 200 patients planned to undergo CRT (CRT group). In the unadjusted situation, progression-free survival and overall survival did not differ statistically between the groups. After matching, both survival outcomes were better in the S group compared to the CRT group. Subanalysis showed both survival outcomes were better in the S group for patients with only stage III disease. However, survival outcomes for stages I, II, and IV were not significantly different between treatment groups. Conclusions: Among patients with resectable disease, survival outcomes in the S group were favored over those of the CRT group. These results indicate that different therapeutic strategies should be used for stage III esophageal cancer than for other stages.
- Subjects
CANCER radiotherapy; CANCER chemotherapy; ESOPHAGEAL cancer patients; ADJUVANT treatment of cancer; PROPORTIONAL hazards models; KAPLAN-Meier estimator; PROGRESSION-free survival
- Publication
International Journal of Clinical Oncology, 2016, Vol 21, Issue 5, p890
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-016-0963-3