Survival benefit of surgery with radiotherapy vs surgery alone to patients with T2-3N0M0 stage esophageal adenocarcinoma
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Yaqi Song1,*, Guangzhou Tao1, Qing Guo3,*, Xi Yang2,*, Hongcheng Zhu2,*, Wanwei Wang1, Xinchen Sun2
1Department of Radiation Oncology, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an 223300, China
2Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
3Department of Oncology, Taizhou people’s hospital, Taizhou 225300, China
*These authors have contributed equally to this work
Guangzhou Tao, e-mail: [email protected]
Xinchen Sun, e-mail: [email protected]
Keywords: esophageal cancer, adenocarcinoma, radiotherapy, surgery, SEER program
Received: August 02, 2015 Accepted: January 14, 2016 Published: February 8, 2016
Background & Aims: This study is designed to analyze survival benefit of (neo-) adjuvant radiotherapy to patients with T2-3N0M0 stage esophageal adenocarcinoma (EAC).
Methods: T2-3N0M0 stage EAC patients from 2004 to 2012 were searched from the Surveillance Epidemiology and End Results (SEER) data. Clinical factors including age, sex, race were summarized. Univariate, multivariate analysis, and stratified cox analysis based on different T stages were performed to explore the survival effect of (neo-)adjuvant radiotherapy to T2-3N0M0 stage EAC.
Results: T2-3N0M0 stage EAC patients with surgery were more likely to be white race, T3 stage. Univariate analysis showed sex, age, and T stage were the prognostic factors of survival (P<0.05). Multivariate analysis proved (neo-)adjuvant radiotherapy can prolong survival time of T2-3N0M0 stage EAC (P<0.05). Further analysis based on different T stages showed that both neoadjuvant radiotherapy (HR 0.615; 95% CI 0.475-0.797) and adjuvant radiotherapy (HR 0.597; 95% 0.387-0.921) significantly reduced the risk of death of T3N0M0 stage EAC, but neither of which significantly reduced death risk of T2N0M0 stage EAC (P>0.05).
Conclusions: sex, age are the independent prognostic factors of T2-3N0M0 EAC. Significant survival benefit of (neo-)adjuvant radiotherapy is only observed in patients with T3N0M0 stage EAC, but not in those with T2N0M0 stage.
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