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Comparison between surgery and definitive chemoradiotherapy for patients with resectable esophageal squamous cell carcinoma: a propensity score analysis

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Abstract

Purpose

Our intent was to compare survival following neoadjuvant chemotherapy followed by surgery versus chemoradiotherapy (CRT) among patients with potentially resectable esophageal squamous cell carcinoma.

Methods

Information about 406 consecutive esophageal cancer patients with resectable disease who underwent surgery with neoadjuvant chemotherapy consisting of cisplatin plus 5-fluorouracil or who underwent definitive CRT was reviewed. The survival outcomes were analyzed using the Kaplan–Meier method and propensity score-adjusted Cox proportional hazards models. Relevant variables were included in the propensity score model.

Results

Overall, 206 patients planned to undergo surgery (S group) and 200 patients planned to undergo CRT (CRT group). In the unadjusted situation, progression-free survival and overall survival did not differ statistically between the groups. After matching, both survival outcomes were better in the S group compared to the CRT group. Subanalysis showed both survival outcomes were better in the S group for patients with only stage III disease. However, survival outcomes for stages I, II, and IV were not significantly different between treatment groups.

Conclusions

Among patients with resectable disease, survival outcomes in the S group were favored over those of the CRT group. These results indicate that different therapeutic strategies should be used for stage III esophageal cancer than for other stages.

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Authors and Affiliations

  1. Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan

    Motoo Nomura, Azusa Komori, Yukiya Narita, Toshiki Masuishi, Hiroya Taniguchi, Shigenori Kadowaki, Takashi Ura, Masashi Andoh & Kei Muro

  2. Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan

    Motoo Nomura & Manabu Muto

  3. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan

    Isao Oze

  4. Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan

    Takeshi Kodaira & Hiroyuki Tachibana

  5. Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan

    Tetsuya Abe & Norihisa Uemura

  6. Department of Endoscopy, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan

    Masahiro Tajika & Yasumasa Niwa

Authors
  1. Motoo Nomura
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  2. Isao Oze
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  3. Takeshi Kodaira
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  4. Tetsuya Abe
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  5. Azusa Komori
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  6. Yukiya Narita
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  9. Shigenori Kadowaki
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  10. Takashi Ura
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  11. Masashi Andoh
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  12. Hiroyuki Tachibana
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  13. Norihisa Uemura
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  14. Masahiro Tajika
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  15. Yasumasa Niwa
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  16. Manabu Muto
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  17. Kei Muro
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Corresponding author

Correspondence to Motoo Nomura.

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None of the authors has identified a conflict of interest.

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Nomura, M., Oze, I., Kodaira, T. et al. Comparison between surgery and definitive chemoradiotherapy for patients with resectable esophageal squamous cell carcinoma: a propensity score analysis. Int J Clin Oncol 21, 890–898 (2016). https://doi.org/10.1007/s10147-016-0963-3

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  • DOI: https://doi.org/10.1007/s10147-016-0963-3

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