Survival comparison between radical surgery and definitive chemoradiation in 267 esophageal squamous cell carcinomas in a single institution: A propensity-matched study
Autor: | Kazuhiko Yamada, Hideomi Yamashita, Osamu Abe, Kae Okuma, Yasuyuki Seto, Kazuhiko Mori, Takashi Fukuda, Keiichi Nakagawa, Tomoki Kiritooshi, Michio Kaminishi, Ryousuke Takenaka |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
Esophageal Neoplasms Cancer Treatment lcsh:Medicine law.invention 0302 clinical medicine Randomized controlled trial law Antineoplastic Combined Chemotherapy Protocols Medicine and Health Sciences Stage (cooking) lcsh:Science Aged 80 and over Multidisciplinary Pharmaceutics Squamous Cell Carcinomas Chemoradiotherapy Esophageal cancer Middle Aged Surgical Oncology Oncology 030220 oncology & carcinogenesis Carcinoma Squamous Cell 030211 gastroenterology & hepatology Female Esophageal Squamous Cell Carcinoma Fluorouracil Research Article Clinical Oncology medicine.medical_specialty Esophageal Cancer Radiation Therapy Surgical and Invasive Medical Procedures Carcinomas 03 medical and health sciences Cancer Chemotherapy Digestive System Procedures Drug Therapy Gastrointestinal Tumors medicine Chemotherapy Humans Radical surgery Survival analysis Radical Surgery Aged Esophageal disease business.industry lcsh:R Cancers and Neoplasms medicine.disease Survival Analysis Surgery Propensity score matching lcsh:Q Clinical Medicine Cisplatin business Combination Chemotherapy |
Zdroj: | PLoS ONE PLoS ONE, Vol 12, Iss 5, p e0177133 (2017) |
ISSN: | 1932-6203 |
Popis: | Objective To compare radical surgery with definitive chemoradiation (CRT) for esophageal squamous cell carcinoma using propensity score (PS) matching at our single institution. Materials and methods A total of 386 consecutive, surgically treated and 243 CRT-treated cases between 2001 and 2014 were analyzed. PS was calculated using multivariable analysis (logistic regression) for pairs of variables such as treatment time, age, sex, primary tumor location, clinical stage, and clinical T- and N-stage for patients after excluding clinical T4 and M1 cases. According to PS, 133 surgically-treated and 134 CRT-treated cases were selected randomly by software. Results The patients’ median age was 68 years in the CRT group and 71 years in the surgery group. Clinical stage II-III, T3, N0 (according to the 7th American Joint Committee on Cancer-2009), and upper plus middle thoracic esophageal disease were seen in 68%, 44%, 54%, and 59%, respectively, in the CRT group and 64%, 47%, 55%, and 64%, respectively, in the surgery group. The 3- and 5-year overall survival was 47.1% and 34.0% in the CRT group and 68.3% and 54.4% in the surgery group (p = 0.0019). The 3- and 5-year progression-free survival was 45.3% and 38.8% in the CRT group and 61.1% and 54.4% in the surgery group (p = 0.022). Conclusion CRT may be inferior to surgery in survival, although a selection bias for patients selected for a non-operative approach cannot be excluded, especially since surgery is the standard of care at this institution. A prospective randomized clinical trial will be necessary to draw a definite conclusion. |
Databáze: | OpenAIRE |
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