Chen Peinan, Zhao Xueke, Zhou Fuyou, Song Xin, Hu Shoujia, Jin Yan, Wang Xianzeng, Han Xuena, Fan Zongmin, Wang Ran, Li Bei, Han Wenli, Wang Panpan, Li Jilin, Wan Lixin, Zhang Liguo, Bao Qide, Chang Fubao, Qin Yanru, Chang Zhiwei, Ku Jianwei, Yang Haijun, Yuan Ling, Ren Jingli, Li Xuemin, Wang Lidong
State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang 455000, China.
Cancer Biol Med. 2020 Feb 15;17(1):219-226. doi: 10.20892/j.issn.2095-3941.2019.0268.
There are no comprehensive studies on survival outcomes and optimal treatment protocols for cervical esophageal cancer (CEC), due to its rare clinical prevalence. Our objective was to determine the relationship between pathological characteristics, treatment protocols, and survival outcomes in Chinese CEC patients. A total of 500 Chinese CEC patients were selected from our 500,000 esophageal and gastric cardia carcinoma database (1973-2018). There were two main groups: patients treated with surgery, and patients receiving non-surgical treatments (radiotherapy, radiochemotherapy, and chemotherapy). The Chi-square test and Kaplan-Meier method were used to compare the continuous variables and survival. Among the 500 CEC patients, 278 (55.6%) were male, and the median age was 60.9 ± 9.4 years. A total of 496 patients (99.2%) were diagnosed with squamous cell carcinoma. In 171 (34.2%) patients who received surgery, 22 (12.9%) had undergone laryngectomy. In 322 (64.4%) patients who received non-surgical treatments, 245 (76.1%) received radiotherapy. Stratified survival analysis showed that only T stage was related with survival outcomes for CEC patients in the surgical group, and the outcomes between laryngectomy and non-laryngectomy patients were similar. It was noteworthy that the 5-year survival rate was similar in CEC patients among the different groups treated with surgery, radiotherapy, chemotherapy, or radiochemotherapy ( = 0.244). The CEC patients had similar survival outcomes after curative esophagectomy and radiotherapy, including those with or without total laryngectomy. These findings suggest that radiotherapy could be the initial choice for treatment of Chinese CEC patients.
由于宫颈段食管癌（CEC）临床发病率低，目前尚无关于其生存结局和最佳治疗方案的全面研究。我们的目的是确定中国CEC患者的病理特征、治疗方案与生存结局之间的关系。我们从50万例食管癌和贲门癌数据库（1973 - 2018年）中选取了500例中国CEC患者。主要分为两组：接受手术治疗的患者和接受非手术治疗（放疗、放化疗和化疗）的患者。采用卡方检验和Kaplan-Meier方法比较连续变量和生存率。在500例CEC患者中，278例（55.6%）为男性，中位年龄为60.9±9.4岁。共有496例患者（99.2%）被诊断为鳞状细胞癌。在171例（34.2%）接受手术的患者中，22例（12.9%）接受了喉切除术。在322例（64.4%）接受非手术治疗的患者中，245例（76.1%）接受了放疗。分层生存分析显示，手术组中只有T分期与CEC患者的生存结局相关，喉切除和未喉切除患者的结局相似。值得注意的是，接受手术、放疗、化疗或放化疗的不同组CEC患者的5年生存率相似（ = 0.244）。根治性食管切除和放疗后，CEC患者的生存结局相似，包括有或没有行全喉切除术的患者。这些发现表明，放疗可能是中国CEC患者治疗的首选。
