Comparative analysis of endoscopic R0 resection followed by additional chemoradiotherapy for early stage esophageal cancer compared with esophagectomy: A multi-center study from ECETC
10.7507/1007-4848.201803029
- VernacularTitle:早期食管鳞癌内镜下R0切除后追加放（化）疗与食管癌根治术的比较分析：来自ECETC协作研究组的多中心研究
- Author:
HUANG Binhao
1
;
WANG Shengfei
1
;
LIU Zhiguo
2
;
LI Zhigang
3
;
LUO Kongjia
4
;
BAI Jianying
5
;
PENG Xue
5
;
LIU Xiaofeng
1
;
WEI Zhi
6
;
JIN Peng
7
;
CHEN Yanyan
8
;
XIAGN Jiaqing
1
;
ZHANG Yawei
1
;
CHEN Sufeng
1
;
XIE Juntao
1
;
ZHUGE Lingdun
1
;
CHEN Haiquan
1
;
ZHANG Jie
9
,
10
Author Information
1. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R.China
2. Department of Gastroenterology, Xijing Hospital, Xian, 710000, P.R.China
3. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, 200030, P.R.China
4. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, 510000, P.R.China
5. Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, P.R.China
6. Department of Gastroenterology, Jinan Military General Hospital, Jinan, 250000, P.R.China
7. Department of Gastroenterology, Wuhan General Hospital of Guangzhou Military, Guangzhou, 510000, P.R.China
8. Department of Respiratory Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, 200030, P.R.China
9. 1. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R.China
10. 9. Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Corresponding author: ZHANG Jie, Email: zhangjie2289@hotmail.com
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
endoscopic resection;
adjuvant radiotherapy;
adjuvant chemotherapy;
esophagectomy;
propensity score
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(6):466-470
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the strategy of chemoradiotherapy following endoscopic R0 resection for esophageal cancer in M3-T1b stage. Methods There were 45 esophageal cancer patients with M3-T1b stage with endoscopic R0 resection followed by additional chemoradiotherapy from ECETC (Esophageal Cancer Endoscopic Therapy Consortium) as a trial group with 34 males and 11 females at age of 61.37±7.14 years. There were 90 patients with esophagectomy from Fudan University Shanghai Cancer Center as a control group with 63 males and 27 females at age of 61.04±8.17 years. Propensity score match (1:2) was used to balance the factors: gender, age, position, depth of invasion and lymphovascular invasion (LVI), which may influence the outcomes. Overall survival (OS) rate, relapse free survival (RFS) rate, and local recurrence rate were compared between the two groups. Result There was no statistical difference (HR=2.66 with 95%CI 0.87 to 8.11, P=0.179) in terms of OS rate between the two groups. One, two and three years overall survival rate of patients in the control group was 93%, 86%, and 84%, respectively. Nobody died in the trial group within 3 years after surgery. The RFS rate between the two groups didn’t significantly differ (HR=1.48, 95% CI 0.66 to 3.33, P=0.389). One, two and three years RFS rate of patients in the contorl group was 87%, 78%, and 76%, respectively, while 97%, 93%, and 73% in the trial group, respectively. The local recurrence rates between the two groups didn’t significantly differ either ( HR=0.53，95%CI 0.13 to 2.18, P=0.314). One, two and three years local recurrence rate of patients in the control group was 5%, 6% and 6%, respectively, while 0%, 0% and 21% in the trial group, respectively. Conclusion Similar outcomes are found regarding OS, RFS and local recurrence rates between the two groups. The strategy of endoscopic R0 resection followed by additional chemoradiotherapy has prospect for the treatment of esophageal cancer in M3-T1b stage. And this kind of therapy may be provided for those with risk factors or can not tolerate surgery.
