Survival benefit of surgery to patients with esophageal squamous cell carcinoma

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.

Neoadjuvant or Definitive Chemoradiation for Locoregional Esophageal Cancer and its Outcome at South Egypt Cancer Institute (Retrospective Study)

“…The median PFS was 17 months and 3-year PFS was 32%. These results were comparable to Song et al, they reported median OS of 23 months (3-year OS=37%), and median PFS of 21 months (3-year PFS=31%), in spite of using different chemotherapy protocol in definitive chemoradiation (Paclitaxel/Oxaloplatin) [33] .…”

“…Regarding the other prognostic factors affecting the survival; the disease stage was a significant factor affecting both OS and PFS, our results were consistent with Haisley et al, [25] who reported a significant impact of disease stage on survival rates. Another investigators were reported that clinical T4 disease and absence of pathologic complete response were independently associated with inferior overall and disease-free survival [33] .…”

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

“…Despite improvements in diagnosis and treatments of esophageal cancer patients, overall 5-year survival rates were still very low (-40%) (1,2). Esophagectomy is the standard strategy for resectable EC.…”

Lymph Node and Bone Marrow Micrometastases Define the Prognosis of Patients with pN0 Esophageal Cancer

“…Esophageal carcinoma (EC) is an aggressive tumor entity with a high rate of local recurrences and distant metastases, even after curative R0 resection in patients without lymph node metastases defined by routine histopathological examination (pN0) [1][2][3]. Although postoperative morbidity and mortality rates have declined over the past decade, survival rates remain poor with a median survival of 16-20 months even after curative treatment [4,5]. Metastatic lymph node invasion is still the strongest prognostic factor for overall survival and tumor-related death following esophagectomy [6].…”