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Definitive chemoradiotherapy versus esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma: A retrospective study

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Abstract
Background and purpose: This study aimed to determine the equivalence between definitive chemoradiotherapy (DCRT) and radical esophagectomy in clinical T1bN0M0 esophageal squamous cell carcinoma (ESCC). Materials and methods: Among 282 patients with cT1bN0M0 ESCC, 238 underwent radical esophagectomy and 44 underwent DCRT. Both treatments were retrospectively compared overall survival (OS), progression-free survival (PFS), and complications. Results: The DCRT group exhibited poorer patient characteristics than the surgery group, especially with mean age (73 vs. 63 years), Eastern Cooperative Oncology Group (ECOG) status, and Charlson Comorbidity Index (p < 0.001, each). The median follow-up duration was 49.5 (range, 0.4-97.0) and 45.5 months (range, 5.0-112.0) in the surgery and DCRT groups, respectively. In the DCRT group, clinical complete response was achieved in 43 patients (97.7%) at 1 month after treatment. The 5-year OS rates were 75.8% and 68.8% (p = 0.135) and the 5-year PFS were 63.8% and 57.8% (p = 0.637) for the surgery and DCRT groups, respectively. Local recurrence rates were identical between the two groups (11.4% and 11.4%), but the distant metastasis rate was lower in the DCRT group (n = 1, 2.27% vs. n = 29, 12.15%). Grade 3-4 hematologic toxicities were observed in 11 patients (25%) of the DCRT group, and 56 patients (23.5%) in the surgery group showed grade 3-5 surgical complications, including mortality (n = 5). Conclusion: Based on the non-inferior survival rates, recurrence patterns, and complication rates without critical surgical mortality, DCRT was comparable to esophagectomy for cT1bN0 esophageal squamous cell carcinoma. (c) 2021 Published by Elsevier B.V. Radiotherapy and Oncology 162 (2021) 112-118
Author(s)
조윤영유제상송계진장정윤유예진김성배박숙련김용희김형렬김종훈
Issued Date
2021
Type
Article
Keyword
Care and treatmentComorbidityComplications and side effectscT1bN0M0Definitive chemoradiotherapy (DCRT)Esophageal cancerEsophageal squamous cell carcinoma (ESCC)MetastasisMortalityRadical esophagectomySquamous cell carcinoma
DOI
10.1016/j.radonc.2021.07.006
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8064
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2552996661&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Definitive%20chemoradiotherapy%20versus%20esophagectomy%20in%20patients%20with%20clinical%20T1bN0M0%20esophageal%20squamous%20cell%20carcinoma:%20A%20retrospective%20study&amp;offset=0&amp;pcAvailability=true
Publisher
RADIOTHERAPY AND ONCOLOGY
Location
네덜란드
Language
한국어
ISSN
0167-8140
Citation Volume
162
Citation Number
9
Citation Start Page
112
Citation End Page
118
Appears in Collections:
Medicine > Medicine
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