Journal
JOURNAL OF CANCER
Volume 8, Issue 4, Pages 683-690Publisher
IVYSPRING INT PUBL
DOI: 10.7150/jca.17048
Keywords
Esophageal squamous cell carcinoma; neoadjuvant chemoradiotherapy; definitive chemoradiotherapy; surgery
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Funding
- University Cancer Foundation via the Sister Institution Network Fund at the University of Texas MD Anderson Cancer Center
- National Institutes of Health through M. D. Anderson's Cancer Center Support Grant [CA016672]
- Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry
- National Nature Science Fund [81301932]
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Introduction: We used the TNM staging matched-pair approach to compare the efficacies of surgery after neoadjuvant chemoradiotherapy (NCT), surgery alone and definitive chemoradiotherapy (CCRT) in patients with localized advanced thoracic esophageal squamous cell carcinoma (ESCC). Methods: A total of 642 patients with ESCC from previous studies were studied. Patients whose treatment involved NCT + surgery and surgery alone were compared with patients receiving CCRT. Prospensity score matched-pair comparison based on pre-treatment TNM staging was developed to assess the efficacies of these treatment options. Results: Prospensity score matched-pair comparison to control for bias generated a cohort of 274 patients who were eligible for comparison. The 3-year OS rate was 70.0% in the NCT + surgery group, compared to 51.7% in the surgery group (p=0.000) and 61.9% in the CCRT group (p=0.082). With the TNM staging matched-pair approach, the CCRT group had more upper thoracic ESCC patients (43/92, 46.7%), while the surgery group had more lower thoracic ESCC patients (37/92, 40.2%). The 3-year OS rates were comparable between the surgery alone group and CCRT group (p=0.109). Conclusions: NCT plus surgery was superior in OS to surgery alone or CCRT. The 3-year OS rates were comparable between the surgery alone group and CCRT group with TNM staging matched-pair approach. Further investigation is warranted to confirm these findings.
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