Trimodality Therapy for Esophageal Cancer: Radiation to the Gastric Conduit Is Not Associated With Post-operative Anastomotic Complication

Abstract

ratio for the effect of treatment group on OS. Using only patients in the matched dataset, the distribution of OS was estimated with the Kaplan-Meier method by treatment group. Results: Starting with an unmatched dataset of 978 patients, 582 patients were selected into the matched dataset: 388 in the CRT group and 194 in the chemotherapy alone group. The HR for the group effect was 0.751 (95% CI 0.613-0.920), two-sided p-value of 0.006. Median OS in the CRT group was 21.1 months (95% CI: 17.4-24.0) versus 14.6 months in the CT group (95% CI: 12.2-18.4). Corresponding 5-year OS rates were 23% (95% CI: 18-28%) and 14% (95% CI: 7-21%), respectively. Additionally, male patients (p<0.001) and patients with visceral metastasis (versus nodal metastasis) (pZ0.005) had worse outcomes. Conclusion: In this largest series to date analyzing outcomes in stage IV patients, CRT was associated with improved OS versus CT alone. In view of lack of prospective data in this setting, this evidence will help guide treatment approaches in this uncommon group of patients.