Survival rates and safety associated with chemoradiotherapy followed by surgery and chemoradiotherapy alone for patients with T4 esophageal cancer: a systematic review and meta-analysis

Background Salvage esophagectomy, indicated for some patients with locally recurrent/persistent disease after definitive chemoradiotherapy (dCRT), reportedly has high postoperative complications. This study aims to compare the safety and efficacy of dCRT followed by salvage esophagectomy (DCRE) with planned esophagectomy after neoadjuvant chemoradiotherapy (NCRE) in esophageal squamous cell carcinoma (ESCC). Methods We retrospectively reviewed all locally advanced ESCC patients treated with DCRE or NCRE at Shanghai Chest Hospital from 2018 to 2021. Propensity score matching (PSM) was used to balance baseline differences. DCRE is defined as esophagectomy for recurrent/persistent disease after dCRT. Results A total of 302 patients (41 for DCRE and 261 for NCRE) were included. The median interval of chemoradiotherapy-to-surgery was 47d in NCRE, 43d and 440d in DCRE of persistent disease (n = 24) and recurrence (n = 17), respectively. DCRE was observed with advanced ypT stage (63% vs 38%), poorer differentiation (32% vs 15%) and more lymphovascular invasion (29% vs 11%) compared with NCRE (all p \ 0.05). The above factors were comparable between the two groups after PSM (all p [ 0.05). There were no significant differences before and after PSM in postoperative complications over Clavien-Dindo grade III (e.g., respiratory failure and anastomotic leak), 30/90-day postoperative mortality, and survival. Conclusion Through a standardized surgical procedure in a high-volume center, DCRE exhibited comparable postoperative complications and prognosis with NCRE.

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“…advanced ESCC, which is mainly applied to those who refuse or are unable to tolerate surgery [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, for resectable locally advanced ESCC, nCRT followed by esophagectomy is the standard treatment. However, definitive chemoradiotherapy (dCRT) is also one of the essential treatment strategies for patients with locally advanced ESCC, which is mainly applied to those who refuse or are unable to tolerate surgery [3–5].…”

Section: Introductionmentioning

confidence: 99%

Salvage Esophagectomy After Definitive Chemoradiotherapy for Squamous Cell Esophageal Cancer: A Propensity Score Matching Study in a High‐Volume Center

et al. 2023

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“…Meanwhile, the current clinical treatment strategies for cancer, such as surgery, chemotherapy, and radiotherapy, cause iatrogenic damage and have side effects on the human body, limiting, to a certain extent, the accuracy and efficiency of cancer therapy. Although the treatment methods have advanced in recent decades, there is no significant improvement in survival [ 5 , 6 , 7 , 8 ]. Thus, it is urgent to exploit novel cancer theranostics in order to improve the survival and cure rates for cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Recent Progress in Second Near-Infrared (NIR-II) Fluorescence Imaging in Cancer

et al. 2022

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Cancer continues to be one of the leading causes of death worldwide, and its incidence is on the rise. Although cancer diagnosis and therapy have advanced significantly in recent decades, it is still a challenge to achieve the accurate identification and localization of cancer and to complete tumor elimination with a maximum preservation of normal tissue. Recently, second near-infrared region (NIR-II, 1000–1700 nm) fluorescence has shown great application potential in cancer theranostics due to its inherent advantages, such as great penetration capacity, minimal tissue absorption and scattering, and low autofluorescence. With the development of fluorescence imaging systems and fluorescent probes, tumor detection, margin definition, and individualized therapy can be achieved quickly, enabling an increasingly accurate diagnosis and treatment of cancer. Herein, this review introduces the role of NIR-II fluorescence imaging in cancer diagnosis and summarizes the representative applications of NIR-II image-guided treatment in cancer therapy. Ultimately, we discuss the present challenges and future perspectives on fluorescence imaging in the field of cancer theranostics and put forward our opinions on how to improve the accuracy and efficiency of cancer diagnosis and therapeutics.

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Therapeutic strategy aiming at R0 resection for borderline-resectable esophageal squamous cell carcinoma using induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil

Nakajima

Muroi

Kikuchi

et al. 2023

Gen Thorac Cardiovasc Surg

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Survival rates and safety associated with chemoradiotherapy followed by surgery and chemoradiotherapy alone for patients with T4 esophageal cancer: a systematic review and meta-analysis

Cited by 4 publications

References 68 publications

Salvage Esophagectomy After Definitive Chemoradiotherapy for Squamous Cell Esophageal Cancer: A Propensity Score Matching Study in a High‐Volume Center

Salvage Esophagectomy After Definitive Chemoradiotherapy for Squamous Cell Esophageal Cancer: A Propensity Score Matching Study in a High‐Volume Center

Recent Progress in Second Near-Infrared (NIR-II) Fluorescence Imaging in Cancer

Therapeutic strategy aiming at R0 resection for borderline-resectable esophageal squamous cell carcinoma using induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil

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