Chi Chun-Ling, Gao Xing, Hsieh Hsiang-Yu, Cheng Yi-Hsuan, Yang Zhi-Hao, Chao Yin-Kai
Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University, Taoyuan 333, Taiwan.
Department of Surgery, Erasmus Medical Center, 3015GD Rotterdam, The Netherlands.
Cancers (Basel). 2023 Aug 10;15(16):4049. doi: 10.3390/cancers15164049.
This retrospective study examined outcomes in esophageal squamous cell carcinoma (ESCC) patients who did not undergo surgical resection after neoadjuvant chemoradiotherapy (nCRT).
Patients receiving nCRT between 2012 and 2020 were divided into two groups: group 1 (scheduled surgery) and group 2 (no surgery). Group 2 was further categorized into subgroups based on reasons for not proceeding to surgery: group 2a (disease progression), group 2b (poor general conditions), and group 2c (patient refusal). Overall survival (OS) was the primary outcome.
Group 1 comprised 145 patients, while subgroups 2a, 2b, and 2c comprised 24, 16, and 31 patients, respectively. The 3-year OS rate was significantly lower in group 2 compared with group 1 (34% versus 56%, < 0.001). A subgroup analysis showed varying 3-year OS rates: 13% for group 2a, 25% for group 2b, and 58% for group 2c ( < 0.001). Propensity score matching for group 2c and group 1 revealed no significant difference in 3-year OS rates ( = 0.91).
One-third of ESCC patients receiving nCRT did not undergo surgical resection. Overall survival in this group was generally poorer, except for those who refused surgery (group 2c).
本回顾性研究调查了接受新辅助放化疗（nCRT）后未进行手术切除的食管鳞状细胞癌（ESCC）患者的预后情况。
将2012年至2020年间接受nCRT的患者分为两组：第1组（计划手术）和第2组（未手术）。第2组根据未进行手术的原因进一步分为亚组：2a组（疾病进展）、2b组（一般状况差）和2c组（患者拒绝）。总生存期（OS）是主要结局指标。
第1组包括145例患者，而2a、2b和2c亚组分别包括24例、16例和31例患者。第2组的3年总生存率显著低于第1组（34%对56%，<0.001）。亚组分析显示3年总生存率各不相同：2a组为13%，2b组为25%，2c组为58%（<0.001）。对2c组和第1组进行倾向评分匹配后发现，3年总生存率无显著差异（=0.91）。
接受nCRT的ESCC患者中有三分之一未进行手术切除。除了那些拒绝手术的患者（2c组）外，该组患者的总体生存情况通常较差。
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