J Cancer 2017; 8(4):683-690. doi:10.7150/jca.17048
TNM Staging Matched-pair Comparison of Surgery After Neoadjuvant Chemoradiotherapy, Surgery Alone and Definitive Chemoradiotherapy for Thoracic Esophageal Squamous Cell Carcinoma
1. State Key Laboratory of Oncology in South China;
2. Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China;
3. Department of Radiation Oncology;
4. Department of Thoracic Surgery;
5. Department of Endoscopy;
6. Department of Medical Oncology;
7. Department of Clinical Statistics, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
* contributed equally to this article.
Liu S, Qiu B, Luo G, Liang Y, Zheng Y, Chen Z, Luo K, Xi M, Liu Q, Hu Y, Li Q, Fu J, Liu M, Yang H, Liu H. TNM Staging Matched-pair Comparison of Surgery After Neoadjuvant Chemoradiotherapy, Surgery Alone and Definitive Chemoradiotherapy for Thoracic Esophageal Squamous Cell Carcinoma. J Cancer 2017; 8(4):683-690. doi:10.7150/jca.17048. Available from http://www.jcancer.org/v08p0683.htm
Introduction: We used the TNM staging matched-pair approach to compare the efficacies of surgery after neoadjuvant chemoradiotherapy (NCT), surgery alone and definitive chemoradiotherapy (CCRT) in patients with localized advanced thoracic esophageal squamous cell carcinoma (ESCC). Methods: A total of 642 patients with ESCC from previous studies were studied. Patients whose treatment involved NCT + surgery and surgery alone were compared with patients receiving CCRT. Prospensity score matched-pair comparison based on pre-treatment TNM staging was developed to assess the efficacies of these treatment options. Results: Prospensity score matched-pair comparison to control for bias generated a cohort of 274 patients who were eligible for comparison. The 3-year OS rate was 70.0% in the NCT + surgery group, compared to 51.7% in the surgery group (p=0.000) and 61.9% in the CCRT group (p=0.082). With the TNM staging matched-pair approach, the CCRT group had more upper thoracic ESCC patients (43/92, 46.7%), while the surgery group had more lower thoracic ESCC patients (37/92, 40.2%). The 3-year OS rates were comparable between the surgery alone group and CCRT group (p=0.109). Conclusions: NCT plus surgery was superior in OS to surgery alone or CCRT. The 3-year OS rates were comparable between the surgery alone group and CCRT group with TNM staging matched-pair approach. Further investigation is warranted to confirm these findings.
Keywords: Esophageal squamous cell carcinoma, neoadjuvant chemoradiotherapy, definitive chemoradiotherapy, surgery