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
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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