Department of Gastroenterology, 74734First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Cancer Control. 2021 Jan-Dec;28:10732748211063955. doi: 10.1177/10732748211063955.
The number of patients diagnosed with T1 stage adenocarcinoma of esophagogastric junction (AEGJ) has been increasing. This study was conducted to investigate the effect of different treatment options (surgery, chemoradiation, and surgery+chemoradiation) on long-term survival in patients with T1-stage AEGJ.
We searched the Surveillance, Epidemiology, and End Results (SEER) database to identify the records of patients with T1-stage AEGJ between 2010 and 2018. Patient demographics and cancer parameters were compared among the three groups. The Kaplan-Meier method and Cox proportional hazard modeling were used to compare long-term survival.
Data from 925 T1 stage AEGJ patients (surgery: n=516, surgery+chemoradiation: n=206, chemoradiation: n=203) were collected. We found that the OS and CSS rates of three treatment options had significant difference. Besides, positive nodal status also showed lower OS and CSS rat. Multivariate Cox regression analysis showed that surgery group has much lower risk of death compared with chemoradiation group and similar risk of death compared with surgery+chemoradiation group. Subgroup analysis suggested that in patients with N1-N3 status had higher OS and CSS rates in surgery+chemoradiation group.
Using SEER data, we identified a significant survival advantage with the use of surgery compared to chemoradiation in patients with T1-stage AEGJ while the long-term survival of patients after surgery+chemoradiation group was not significantly different and low risk of death in positive nodal status.
诊断为食管胃结合部（AEGJ）T1 期腺癌的患者数量一直在增加。本研究旨在探讨不同治疗方案（手术、放化疗、手术+放化疗）对 T1 期 AEGJ 患者长期生存的影响。
我们在 Surveillance, Epidemiology, and End Results（SEER）数据库中检索了 2010 年至 2018 年间 T1 期 AEGJ 患者的记录。比较三组患者的人口统计学和癌症参数。采用 Kaplan-Meier 方法和 Cox 比例风险模型比较长期生存。
共收集了 925 例 T1 期 AEGJ 患者（手术组：n=516，手术+放化疗组：n=206，放化疗组：n=203）的数据。我们发现三种治疗方案的 OS 和 CSS 率有显著差异。此外，阳性淋巴结状态也显示出较低的 OS 和 CSS 率。多变量 Cox 回归分析显示，与放化疗组相比，手术组的死亡风险明显降低，与手术+放化疗组的死亡风险相似。亚组分析表明，在 N1-N3 期的患者中，手术+放化疗组的 OS 和 CSS 率较高。
使用 SEER 数据，我们发现与放化疗相比，T1 期 AEGJ 患者使用手术具有显著的生存优势，而手术+放化疗组的长期生存无显著差异，且阳性淋巴结状态的死亡风险较低。
