III期食管腺癌：根治性放化疗与放化疗联合手术对比

Stage III esophageal adenocarcinoma: definitive chemoradiation vs. chemoradiation plus surgery.

作者信息

Schlottmann Francisco, Strassle Paula D, Gaber Charles, Patti Marco G

机构信息

Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.

Department of Surgery, University of North Carolina, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA.

出版信息

Updates Surg. 2018 Dec;70(4):423-426. doi: 10.1007/s13304-018-0541-5. Epub 2018 Jun 20.

DOI:10.1007/s13304-018-0541-5

PMID:29926306

Abstract

The optimal management of patients with locally advanced esophageal cancer remains under debate. We aimed to compare the long-term survival outcomes between definitive chemoradiation (dCR) and chemoradiation plus surgery (CRS) in patients with stage III esophageal adenocarcinoma (EAC). Using the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program registry, adults (≥ 18 years old) with diagnosis of AJCC 6th edition stage III EAC (T3/N1, T4/N0, and T4/N1) between 2004 and 2014 were included. A multivariable Cox regression was used to assess the effect of dCR and CRS on mortality. Of the 2633 patients included, 1115 (42%) underwent Dcr, and 1518 (58%) underwent CRS. The 5-year survival rate was 13% for patients undergoing dCR and 27% for patients undergoing CRS (p < 0.0001). Our observational data suggest that patients with stage III EAC may benefit by the use of esophagectomy after chemoradiotherapy.

摘要

局部晚期食管癌患者的最佳治疗方案仍存在争议。我们旨在比较III期食管腺癌（EAC）患者接受根治性放化疗（dCR）与放化疗联合手术（CRS）后的长期生存结果。利用美国国立癌症研究所监测、流行病学和最终结果（SEER）计划登记处的数据，纳入了2004年至2014年间诊断为AJCC第6版III期EAC（T3/N1、T4/N0和T4/N1）的成年人（≥18岁）。采用多变量Cox回归评估dCR和CRS对死亡率的影响。在纳入的2633例患者中，1115例（42%）接受了dCR，1518例（58%）接受了CRS。接受dCR的患者5年生存率为13%，接受CRS的患者为27%（p<0.0001）。我们的观察数据表明，III期EAC患者在放化疗后行食管切除术可能会获益。