Impact of Postoperative Radiation after Esophagectomy for Esophageal Cancer

Schreiber, David; Rineer, Justin; Vongtama, D.; Wortham, A.; Han, P.; Schwartz, David L.; Choi, Kwang Nam; Rotman, Marvin

doi:10.1097/jto.0b013e3181c5e34f

Cited by 79 publications

(60 citation statements)

References 20 publications

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“…Several prospective randomized studies [1,2,3,5] demonstrated that PORT did not improve overall survival (OS) in thoracic esophageal squamous cell carcinoma (TESCC). Previously [4,6], we stratified patients by stage and lymph node metastasis, finding that PORT improved OS in lymph node-positive or stage III patients, which recent retrospective study findings support [7,8,9]. We also found that PORT reduced intrathoracic and supraclavicular recurrence.…”

Section: Introductionsupporting

confidence: 68%

“…In our previous randomized study [4], we found that PORT improved OS and reduced locoregional recurrence. Other studies also reported the survival benefit of PORT in stage III or lymph node-positive ESCC patients [7,8,9]. However, the PORT methods for TESCC in all of the previously reported randomized clinical trials exclusively involved 2D techniques.…”

Section: Commentmentioning

confidence: 94%

“…However, some of the abovementioned studies did not stratify patients by stage and were likely insufficiently large to detect improvement in survival only for lymph node-positive patients or those with deeply invading tumors. Schreiber et al [8 ]used the Surveillance, Epidemiology, and End Results (SEER) database to retrospectively evaluate the benefit of adjuvant RT in T3-4N0M0 or T1-4N1M0 esophageal cancer patients definitively treated with esophagectomy. The study involved 1,046 patients: 683 (65.3%) had surgery alone; 363 (34.7%) received PORT.…”

Section: Commentmentioning

confidence: 99%

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Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

et al. 2015

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Background: The aim of this study was to retrospectively analyze the effect of postoperative intensity-modulated radiotherapy (IMRT) on recurrence and survival in lymph node-positive or stage III thoracic esophageal squamous cell carcinoma (TESCC) patients, and evaluate its role in TESCC therapy. Methods: We enrolled 538 patients who underwent radical resection with (S + R) or without (S) postoperative IMRT. The median total postoperative IMRT dose was 60 Gy. The Kaplan-Meier method, log-rank test, and chi-square test were used for survival rate calculation, univariate analysis, and sites of failure analysis, respectively. Results: The 5-year overall survival (OS) and disease-free survival rates were 32.7 and 27.3%, respectively. The 5-year OS rates of lymph node-positive S and S + R patients were 28.4 and 38.8%, respectively (p < 0.001). The 5-year OS rates of stage III S and S + R patients were 24.0 and 38.0%, respectively (p = 0.001). Postoperative IMRT resulted in significantly decreased intrathoracic and supraclavicular recurrence, and obviously delayed median local recurrence and systemic metastases. Systemic metastases increased following postoperative IMRT. Conclusion: Postoperative IMRT reduces local recurrence and improves survival in lymph node-positive or stage III TESCC patients, providing a rationale for selection criteria for postoperative IMRT in TESCC.

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Section: Introductionsupporting

confidence: 68%

Section: Commentmentioning

confidence: 94%

Section: Commentmentioning

confidence: 99%

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Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

et al. 2015

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“…Therefore, adjuvant radiotherapy and chemotherapy should be considered in these patients. Previous studies of typical esophageal SCC (Fok et al, 1993;Schreiber et al, 2010;Berger et al, 2011) have approved that adjuvant radiochemotherapy could decrease loco-regional recurrence and improve the long-term survival. Although such improvements were not observed in our study, the frequency of locoregional recurrence in patients without radiotherapy was significantly higher than for patients who received radiotherapy, showing that postoperative radiotherapy could reduce the locoregional recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Basaloid Squamous Cell Carcinoma of the Esophagus: A Retrospective Analysis of 142 Cases

Zhang¹,

Cheng²,

Xue³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Esophageal cancer is highly lethal with 11,650 (88.7%) estimated deaths among men and 2,850 (81.2%) among women. 2 Taken together with previous population studies, [3][4][5][6][7][8][9] the latter suggests a survival benefit for women when compared with men. The prevalence of the two main histologic subtypes-adenocarcinoma and squamous cell carcinoma-differs depending on geographic location.…”

Section: Introductionmentioning

confidence: 99%

Influence of Sex on the Survival of Patients With Esophageal Cancer

Bohanes

Yang

Chhibar

et al. 2012

JCO

115

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A B S T R A C T PurposeThe prognostic value of sex for esophageal cancer survival is currently unclear, and growing data suggest that hormonal influences may account for incidence disparities between men and women. Therefore, moving from the hypothesis that hormones could affect the prognosis of patients with esophageal cancer, we investigated the primary hypothesis that sex is associated with survival and the secondary hypotheses that the relationship between sex and survival depends, at least in part, on age, histology, and race/ethnicity. Patients and MethodsBy using the SEER databases from 1973 to 2007, we identified 13,603 patients (34%) with metastatic esophageal cancer (MEC) and 26,848 patients (66%) with locoregional esophageal cancer (LEC). Cox proportional hazards model for competing risks were used for analyses. ResultsIn the multivariate analysis, women had longer esophageal cancer-specific survival (ECSS) than men in both MEC (hazard ratio [HR], 0.949; 95% CI, 0.905 to 0.995; P ϭ .029) and LEC (HR, 0.920; 95% CI, 0.886 to 0.955; P Ͻ .001) cohorts. When age and histology were accounted for, there was no difference for ECSS between men and women with adenocarcinoma. In contrast, women younger than age 55 years (HR, 0.896; 95% CI, 0.792 to 1.014; P ϭ .081) and those age 55 years or older (HR, 0.905; 95% CI, 0.862 to 0.950; P Ͻ .001) with squamous cell LEC had longer ECSS than men. In the squamous cell MEC cohort, only women younger than age 55 years had longer ECSS (HR, 0.823; 95% CI, 0.708 to 0.957; P ϭ .011) than men. ConclusionSex is an independent prognostic factor for patients with LEC or MEC. As secondary hypotheses, in comparison with men, women age 55 years or older with squamous cell LEC and women younger than age 55 years with squamous cell MEC have a significantly better outcome. These last two findings need further validation.

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Impact of Postoperative Radiation after Esophagectomy for Esophageal Cancer

Cited by 79 publications

References 20 publications

Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

Clinical Outcomes of Basaloid Squamous Cell Carcinoma of the Esophagus: A Retrospective Analysis of 142 Cases

Influence of Sex on the Survival of Patients With Esophageal Cancer

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