Patterns of recurrence after oesophagectomy and postoperative chemoradiotherapy <i>versus</i> surgery alone for oesophageal squamous cell carcinoma

Hsu, Po Kuei; Chen, H.-S.; Huang, Ching‐Ying; Liu, C.-C.; Hsieh, Chih‐Cheng; Hsu, Han Shui; Wu, Yu‐Chung; Wu, Siao-Chi

doi:10.1002/bjs.10334

Cited by 23 publications

(24 citation statements)

References 18 publications

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“…The 3-year OS for the adjuvant therapy and the surgery alone groups were 50% and 38%, respectively, P=0.006. The 3-year DFS was 46% for the adjuvant CRT group and 36% for the surgery alone group, P=0.006 (55).…”

Section: Current Evidence For Postoperative (Adjuvant) Therapy Of Esomentioning

confidence: 91%

The frontline of esophageal cancer treatment: questions to be asked and answered

Tu¹,

Hsu²

2018

Ann. Transl. Med.

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Section: Current Evidence For Postoperative (Adjuvant) Therapy Of Esomentioning

confidence: 91%

The frontline of esophageal cancer treatment: questions to be asked and answered

Tu¹,

Hsu²

2018

Ann. Transl. Med.

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“…Esophagectomy is the standard strategy for resectable EC. Unfortunately locoregional recurrence [especially lymphatic metastasis (LNM)] was the main failure for these patients (3,4).…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of pattern of recurrence after radical surgery for thoracic esophageal carcinoma with or without postoperative radiotherapy

Wang

Zhang

et al. 2018

Oncol Lett

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Abstract. The present study aimed to investigate the recurrence pattern of thoracic esophageal cancer (TEC) following radical surgery for guiding postoperative radiotherapy (PRT). Patterns of recurrence were analyzed in patients with recurrence for the first time after radical surgery at the First Affiliated Hospital of Anhui Medical University (Anhui, China) from January 2012 to December 2015. A total of 244 patients were reviewed in the study. The mean recurrence time for patients with PRT was >1 month longer than that for patients without PRT. The lymphatic, anastomotic and hematological recurrence ratios were 87.9 vs. 69.2%, 4.0 vs. 11.5% and 8.0 vs. 17.2%, respectively for patients without and with PRT. The most common recurrence regions were staion1 and station 2-4 (30.0 vs. 36.5% and 37.2% vs. 23.1%, respectively, for patients without and with PRT). The lymphatic recurrence of upper TEC was almost in station1 and station 2-4 (infield). The middle and lower TEC also had a high probability of lymphatic recurrence in station 1 and station 2-4 (totally 76.3 vs. 57.6% and 61.9 vs. 61.1%, respectively). The recurrence ratio significantly decreased in station 2-4 (infield) for middle TEC patients with PRT compared with patients without PRT (P= 0.03), while no significant differences in the lymphatic recurrence ratios were observed in other regions (P>0.05). The differences of recurrence ratios in station 7, station 8 and celiac regions (infield) for lower TEC patients without and with PRT also demonstrated no statistical significance (P>0.05). The results of the present study indicated that the lower neck, supraclavicular regions and upper mediastinal regions (station 1, 2 and 4) should be included in the clinic target volume (CTV) for PRT, while lower mediastinal regions, celiac regions and anastomotic may not be included in CTV.

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“…Unlike preoperative radiotherapy, postoperative radiotherapy is based on the precise pathological stage and allows delivery of higher doses to high‐risk volumes and thus reduces toxicities. These advantages are also likely to result in long‐term survival benefits over esophagectomy alone in TESCC patient . Thus, postoperative radiotherapy is regarded as an important treatment choice in China.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, postoperative radiotherapy is regarded as an important treatment choice in China. However, previous studies investigating the efficacy of postoperative radiotherapy in TESCC have all been single‐institution studies and enrolled patients with various disease stages; the results therefore may not be generalizable to all TESCC patients . Furthermore, there have been no well‐designed prospective studies comparing the efficacy of preoperative vs postoperative radiotherapy in TESCC.…”

Section: Introductionmentioning

confidence: 99%

“…These advantages are also likely to result in longterm survival benefits over esophagectomy alone in TESCC patient. [13][14][15] Thus, postoperative radiotherapy is regarded as an important treatment choice in China. However, previous studies investigating the efficacy of postoperative radiotherapy in TESCC have all been single-institution studies and enrolled patients with various disease stages; the results therefore may not be generalizable to all TESCC patients.…”

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confidence: 99%

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Value of radiotherapy in addition to esophagectomy for stage II and III thoracic esophageal squamous cell carcinoma: Analysis of surveillance, epidemiology, and end results database

Ouyang

et al. 2018

Cancer Medicine

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To determine the value of radiotherapy in addition to esophagectomy for stage II and III TESCC. We searched the Surveillance, Epidemiology, and End Results (SEER) database for all cases of stage II‐III TESCC. Patients were grouped as those receiving pre‐ or postoperative radiotherapy plus esophagectomy and those receiving esophagectomy alone. Overall survival (OS) and cancer‐specific survival (CSS) were compared between the groups. Among the 3292 patients, multimodality treatments (pre‐ or postoperative radiotherapy plus surgery) were more effective than surgery alone (5‐year, OS: 17.3% vs 7.9%; P < 0.001; CSS: 51.8% vs 34.9%; P < 0.001). Among the patients receiving multimodality treatments, multivariate analyses revealed stage to be the most significant prognostic factor for OS (II vs III, HR, 0.726; P < 0.001), but the sequence of radiotherapy and surgery was only of the marginal significance (pre‐ vs postoperative, HR, 0.875; P = 0.093). Preoperative radiotherapy provided significantly better survival than postoperative radiotherapy in stage III disease (5‐year, OS: 13.0% vs 11.0%, P < 0.04; CSS: 49.2% vs 31.7%, P < 0.003), but not in stage II disease (5‐year OS: 23.5% vs 21.0%, P = 0.519; CSS: 62.0% vs 53.4%, P = 0.075). Radiotherapy in addition to esophagectomy provides better outcomes than esophagectomy alone for in stage II‐III TESCC. Preoperative radiotherapy followed by surgery appears to be the optimal treatment strategy in stage III TESCC.

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Patterns of recurrence after oesophagectomy and postoperative chemoradiotherapy versus surgery alone for oesophageal squamous cell carcinoma

Abstract: Oesophagectomy with postoperative chemoradiotherapy was associated with longer survival and lower recurrence rates, especially at a locoregional level, compared with surgery alone.

Cited by 23 publications

References 18 publications

The frontline of esophageal cancer treatment: questions to be asked and answered

The frontline of esophageal cancer treatment: questions to be asked and answered

A retrospective study of pattern of recurrence after radical surgery for thoracic esophageal carcinoma with or without postoperative radiotherapy

Value of radiotherapy in addition to esophagectomy for stage II and III thoracic esophageal squamous cell carcinoma: Analysis of surveillance, epidemiology, and end results database

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