Department of Gastroenterology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, Guangxi, P.R. China.
Department of Thoracic Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, Guangxi, P.R. China.
Sci Rep. 2024 Nov 21;14(1):28898. doi: 10.1038/s41598-024-80653-2.
To compare the survival outcomes of patients with stage T2N0M0 esophageal cancer treated with surgery alone versus those treated with neoadjuvant chemoradiotherapy followed by surgery. Patients with stage T2N0M0 esophageal cancer, who either underwent surgery alone or received neoadjuvant chemoradiotherapy followed by surgery, were extracted from the Surveillance, Epidemiology, and End Results database covering the period from 2000 to 2020. Cancer-specific survival (CSS) and overall survival (OS) between the two treatment groups were compared. A total of 583 patients were included: 267 (45.8%) received surgery alone, while 316 (54.2%) underwent neoadjuvant chemoradiotherapy followed by surgery. Prior to propensity score matching, no significant differences were observed between the surgery alone and neoadjuvant chemoradiotherapy groups in terms of 5-year CSS (60.86% vs. 59.02%; hazard ratio [HR] = 1.01, 95% confidence interval [CI]: 0.79-1.29; P = 0.916) and OS (50.64% vs. 49.81%; HR = 0.91, 95% CI: 0.75-1.12; P = 0.375). After propensity score matching, the 5-year CSS (66.43% vs. 56.67%; HR = 1.21, 95% CI: 0.89-1.64; P = 0.225) and OS (56.49% vs. 47.37%; HR = 1.09, 95% CI: 0.85-1.40; P = 0.481) remained statistically similar between the two groups. Subgroup analyses of patients with squamous cell carcinoma and adenocarcinoma revealed no significant differences in survival outcomes between the treatment modalities for either histological subtype. Neoadjuvant chemoradiotherapy followed by surgery does not confer a survival advantage over surgery alone in patients with stage T2N0M0 esophageal cancer, irrespective of histological subtype.
比较单独手术治疗与新辅助放化疗后手术治疗 T2N0M0 期食管鳞癌患者的生存结局。从 2000 年至 2020 年期间的监测、流行病学和最终结果数据库中提取接受单纯手术或新辅助放化疗后手术的 T2N0M0 期食管鳞癌患者。比较两组间的癌症特异性生存率（CSS）和总生存率（OS）。共纳入 583 例患者：267 例（45.8%）接受单纯手术，316 例（54.2%）接受新辅助放化疗后手术。在进行倾向评分匹配之前，单纯手术组和新辅助放化疗组在 5 年 CSS（60.86%比 59.02%；风险比[HR] = 1.01，95%置信区间[CI]：0.79-1.29；P = 0.916）和 OS（50.64%比 49.81%；HR = 0.91，95% CI：0.75-1.12；P = 0.375）方面无显著差异。在进行倾向评分匹配后，5 年 CSS（66.43%比 56.67%；HR = 1.21，95% CI：0.89-1.64；P = 0.225）和 OS（56.49%比 47.37%；HR = 1.09，95% CI：0.85-1.40；P = 0.481）在两组间仍具有统计学相似性。对鳞癌和腺癌患者的亚组分析显示，两种治疗方式在任何组织学亚型的生存结局方面均无显著差异。对于 T2N0M0 期食管鳞癌患者，新辅助放化疗后手术与单纯手术相比并不能带来生存优势，无论组织学亚型如何。
