Department of Medical Oncology, Shantou Central Hospital, Shantou, Guangdong, China.
Department of Radiation Oncology, Shantou Central Hospital, Shantou, Guangdong, China.
Asian J Surg. 2019 Jan;42(1):350-355. doi: 10.1016/j.asjsur.2018.04.009. Epub 2018 May 22.
To compare overall survival in patients with clinical T1-3N0-1 thoracic esophageal squamous cell carcinoma treated with surgery or definitive chemoradiation therapy (CRT).
We used propensity-score matching to derive 1:1 cohorts of surgery versus definitive CRT. Statistical analysis was performed using χ or Fisher's exact tests. Survival functions were estimated using Kaplan-Meier survival plots, and survival distributions were compared using log-rank tests. Cox proportional hazards modeling was used to analyze the factors affecting overall survival.
A total of 334 patients treated with surgery and 252 treated with definitive CRT were included. 129 (38.6%) of 334 patients had recurrence after surgery versus 118 (46.8%) of 252 after definitive CRT. Before matching, the median overall survival were 39.5 months (95% CI, 28.8-50.2) and 23.5 months (95% CI, 18.5-28.5) (P < 0.001) in the surgery and definitive CRT group, respectively. After matching (112 patients in each treatment group), median overall survival was 43.6 months (95% CI, 28.1-59.1) with surgery versus 19.3 months (95% CI, 14.4-24.2) with CRT (P < 0.001).
In this retrospective analysis, surgery was associated with better overall survival compared with definitive CRT.
比较手术或根治性放化疗（CRT）治疗临床 T1-3N0-1 期胸段食管鳞癌患者的总生存率。
我们使用倾向评分匹配，从手术组和根治性 CRT 组中得出 1:1 的匹配队列。使用 χ 或 Fisher 精确检验进行统计学分析。使用 Kaplan-Meier 生存图估计生存函数，并使用对数秩检验比较生存分布。使用 Cox 比例风险模型分析影响总生存率的因素。
共纳入 334 例手术治疗患者和 252 例根治性 CRT 治疗患者。334 例手术患者中有 129 例（38.6%）发生术后复发，252 例根治性 CRT 患者中有 118 例（46.8%）发生术后复发。在匹配前，手术组和根治性 CRT 组的中位总生存期分别为 39.5 个月（95%CI，28.8-50.2）和 23.5 个月（95%CI，18.5-28.5）（P<0.001）。匹配后（每组各 112 例患者），手术组的中位总生存期为 43.6 个月（95%CI，28.1-59.1），CRT 组为 19.3 个月（95%CI，14.4-24.2）（P<0.001）。
在这项回顾性分析中，与根治性 CRT 相比，手术与更好的总生存率相关。
