非根治性内镜切除术后辅助放化疗用于浅表性鳞状细胞癌器官保留策略的疗效：一项多中心西方研究

Efficacy of Organ Preservation Strategy by Adjuvant Chemoradiotherapy after Non-Curative Endoscopic Resection for Superficial SCC: A Multicenter Western Study.

作者信息

Berger Arthur, Perrod Guillaume, Pioche Mathieu, Barret Maximilien, Cesbron-Métivier Elodie, Lépilliez Vincent, Hupé Marianne, Perez-Cuadrado-Robles Enrique, Cholet Franck, Daubigny Augustin, Texier Charles, Ali Einas Abou, Chabrun Edouard, Jacques Jérémie, Wallenhorst Timothee, Chevaux Jean Baptiste, Schaefer Marion, Cellier Christophe, Rahmi Gabriel

机构信息

CHU Bordeaux, Department of Gastroenterology and Digestive Endoscopy, Univ. Bordeaux, 33000 Bordeaux, France.

Department of Gastroenterology and Digestive Endoscopy, Georges Pompidou European Hospital, Paris-Cité University, 75015 Paris, France.

出版信息

Cancers (Basel). 2023 Jan 18;15(3):590. doi: 10.3390/cancers15030590.

DOI:10.3390/cancers15030590

PMID:36765546

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9913357/

Abstract

BACKGROUND

In case of high risk of lymph node invasion after endoscopic resection (ER) of superficial esophageal squamous cell carcinoma (SCC), adjuvant chemoradiotherapy (CRT) can be an alternative to surgery. We assessed long-term clinical outcomes of adjuvant therapy by CRT after non-curative ER for superficial SCC.

METHODS

We performed a retrospective multicenter study. From April 1999 to April 2018, all consecutive patients who underwent ER for SCC with tumor infiltration beyond the muscularis mucosae were included.

RESULTS

A total of 137 ER were analyzed. The overall nodal or metastatic recurrence-free survival rate at 5 years was 88% and specific recurrence-free survival rates at 5 years with and without adjuvant therapy were, respectively, 97.9% and 79.1% ( = 0.011). Independent factors for nodal and/or distal metastatic recurrence were age (HR = 1.075, = 0.031), Sm infiltration depth > 200 µm (HR = 4.129, = 0.040), and the absence of adjuvant CRT or surgery (HR = 11.322, = 0.029).

CONCLUSION

In this study, adjuvant therapy is associated with a higher recurrence-free survival rate at 5 years after non-curative ER. This result suggests this approach may be considered as an alternative to surgery in selected patients.

摘要

背景

对于浅表性食管鳞状细胞癌（SCC）内镜切除（ER）后存在淋巴结侵犯高风险的情况，辅助放化疗（CRT）可作为手术的替代方案。我们评估了非根治性ER治疗浅表SCC后行辅助CRT的长期临床结局。

方法

我们进行了一项回顾性多中心研究。纳入1999年4月至2018年4月期间所有因SCC行ER且肿瘤浸润超过黏膜肌层的连续患者。

结果

共分析了137例ER。5年时总的无淋巴结或转移复发生存率为88%，有和无辅助治疗时5年的特异性无复发生存率分别为97.9%和79.1%（P = 0.011）。淋巴结和/或远处转移复发的独立因素为年龄（HR = 1.075，P = 0.031）、黏膜下浸润深度>200 µm（HR = 4.129，P = 0.040）以及未行辅助CRT或手术（HR = 11.322，P = 0.029）。