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Survival benefit of surgery to patients with esophageal squamous cell carcinoma

View Article: PubMed Central - PubMed

ABSTRACT

To assess if surgery provided survival benefit to patients with esophageal squamous cell carcinoma (SCC), we performed a retrospective review of 1230 patients who were newly diagnosed with stage T2-T4 esophageal SCC from 2007 to 2014 in our hospital. There were greater than 70% of patients with age under 65 years, and more than 85% were stage T3-T4 at the time of diagnosis. The median survival time was 1.06 year (95% CI 0.99–1.1 yrs). Survival analyses showed that survival time was significantly associated with age, T stage, clinical lymph node involvement and treatment modality (surgery versus definite chemoradiotherapy). Surgery still possessed a powerful impact on overall survival by multivariable analysis. Death risk of patients treated with curative surgery was significantly lower than those with definite chemoradiotherapy. Furthermore, for patients of stage T3N(+) and T4, surgery combined with (neo-)adjuvant treatment were significantly associated with higher survival rate than surgery alone or definite chemoradiotherapy. In conclusion, the patients who undergo surgery were significantly associated longer survival, therefore, curative resection should be considered for esophageal cancer patients who are medically fit for surgery. Moreover, combined with (neo-)adjuvant treatment is recommended for surgically resectable stage T3-T4 esophageal SCC.

No MeSH data available.


Related in: MedlinePlus

Overall survival in patients with T2-T4 esophageal SCC Kaplan-Meier survival curves of the total 1230 patients with clinical stage T2-T4 and histology confirmed with SCC; and the survival differences according to age (a), clinical T stage (b), and clinical lymph node involvement (c). Additionally, Kaplan-Meier survival curves according to treatment modality (Surgery+/−Neo/adjuvant Tx versus definite CCRT versus palliative treatment) (d).
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f1: Overall survival in patients with T2-T4 esophageal SCC Kaplan-Meier survival curves of the total 1230 patients with clinical stage T2-T4 and histology confirmed with SCC; and the survival differences according to age (a), clinical T stage (b), and clinical lymph node involvement (c). Additionally, Kaplan-Meier survival curves according to treatment modality (Surgery+/−Neo/adjuvant Tx versus definite CCRT versus palliative treatment) (d).

Mentions: From 2007 to 2014, there were 1309 new cases diagnosed with esophageal cancer and with clinical stage T2-T4 and in our hospital. Among these patients, more than 90% was diagnosed with histologically confirmed SCC of esophagus. For clinical stage T2-T4 esophageal cancer, the median survival times were 1.06 year (95% CI 0.99-1.1 yrs) for patients with SCC, and 1.58 year (95% CI 0.85-3.21 yrs) for adenocarcinoma. To focus the role of surgery in the treatment of esophageal SCC, we conducted all further analysis on the basis of 1230 patients with T2-T4 esophageal SCC. The clinical characteristics are listed in Table 1. In our hospital, approximately 15 times as many males as females (1152 males and 78 females) had esophageal SCC diagnosed, and 30% patients received surgery as the major treatment modality for esophageal SCC. By survival analysis for patients with T2-T4 esophageal SCC (Fig. 1a), increasing age was associated with lower survival rates. In addition, as shown in Fig. 1b–c, clinical T stage and clinical lymph node (LN) involvement were significant predictor for prognosis. The 3-year survival rate was 45.9%; 22.9% and 13.7% for clinical T2, T3 and T4, respectively. The median survival time was 1.8 years (95% CI 1.45-2.96 yrs) in patients with clinical N0 and 1 year (95% CI 0.93-1.07 yrs) in those with clinical LN involvement.


Survival benefit of surgery to patients with esophageal squamous cell carcinoma
Overall survival in patients with T2-T4 esophageal SCC Kaplan-Meier survival curves of the total 1230 patients with clinical stage T2-T4 and histology confirmed with SCC; and the survival differences according to age (a), clinical T stage (b), and clinical lymph node involvement (c). Additionally, Kaplan-Meier survival curves according to treatment modality (Surgery+/−Neo/adjuvant Tx versus definite CCRT versus palliative treatment) (d).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5382669&req=5

f1: Overall survival in patients with T2-T4 esophageal SCC Kaplan-Meier survival curves of the total 1230 patients with clinical stage T2-T4 and histology confirmed with SCC; and the survival differences according to age (a), clinical T stage (b), and clinical lymph node involvement (c). Additionally, Kaplan-Meier survival curves according to treatment modality (Surgery+/−Neo/adjuvant Tx versus definite CCRT versus palliative treatment) (d).
Mentions: From 2007 to 2014, there were 1309 new cases diagnosed with esophageal cancer and with clinical stage T2-T4 and in our hospital. Among these patients, more than 90% was diagnosed with histologically confirmed SCC of esophagus. For clinical stage T2-T4 esophageal cancer, the median survival times were 1.06 year (95% CI 0.99-1.1 yrs) for patients with SCC, and 1.58 year (95% CI 0.85-3.21 yrs) for adenocarcinoma. To focus the role of surgery in the treatment of esophageal SCC, we conducted all further analysis on the basis of 1230 patients with T2-T4 esophageal SCC. The clinical characteristics are listed in Table 1. In our hospital, approximately 15 times as many males as females (1152 males and 78 females) had esophageal SCC diagnosed, and 30% patients received surgery as the major treatment modality for esophageal SCC. By survival analysis for patients with T2-T4 esophageal SCC (Fig. 1a), increasing age was associated with lower survival rates. In addition, as shown in Fig. 1b–c, clinical T stage and clinical lymph node (LN) involvement were significant predictor for prognosis. The 3-year survival rate was 45.9%; 22.9% and 13.7% for clinical T2, T3 and T4, respectively. The median survival time was 1.8 years (95% CI 1.45-2.96 yrs) in patients with clinical N0 and 1 year (95% CI 0.93-1.07 yrs) in those with clinical LN involvement.

View Article: PubMed Central - PubMed

ABSTRACT

To assess if surgery provided survival benefit to patients with esophageal squamous cell carcinoma (SCC), we performed a retrospective review of 1230 patients who were newly diagnosed with stage T2-T4 esophageal SCC from 2007 to 2014 in our hospital. There were greater than 70% of patients with age under 65 years, and more than 85% were stage T3-T4 at the time of diagnosis. The median survival time was 1.06 year (95% CI 0.99–1.1 yrs). Survival analyses showed that survival time was significantly associated with age, T stage, clinical lymph node involvement and treatment modality (surgery versus definite chemoradiotherapy). Surgery still possessed a powerful impact on overall survival by multivariable analysis. Death risk of patients treated with curative surgery was significantly lower than those with definite chemoradiotherapy. Furthermore, for patients of stage T3N(+) and T4, surgery combined with (neo-)adjuvant treatment were significantly associated with higher survival rate than surgery alone or definite chemoradiotherapy. In conclusion, the patients who undergo surgery were significantly associated longer survival, therefore, curative resection should be considered for esophageal cancer patients who are medically fit for surgery. Moreover, combined with (neo-)adjuvant treatment is recommended for surgically resectable stage T3-T4 esophageal SCC.

No MeSH data available.


Related in: MedlinePlus