Impact of Treatment Modalities on Survival of Patients With Locoregional Esophageal Squamous-Cell Carcinoma in Taiwan

Abstract

The optimal treatment modality for locoregional esophageal squamous-cell carcinoma (ESCC) is still undetermined. This study investigated the treatment modalities affecting survival of patients with ESCC in Taiwan.Data on 6202 patients who underwent treatment for locoregional esophageal squamous-cell carcinoma during 2008 to 2012 in Taiwan were collected from the Taiwan Cancer Registry. Patients were stratified by clinical stage. The major treatment approaches included definitive chemoradiotherapy, preoperative chemoradiation followed by esophagectomy, esophagectomy followed by adjuvant therapy, and esophagectomy alone. The impact of different treatment modalities on overall survival was analyzed.The majority of patients had stage III disease (n = 4091; 65.96%), followed by stage II (n = 1582, 25.51%) and stage I cancer (n = 529, 8.53%). The 3-year overall survival rates were 60.65% for patients with stage I disease, 36.21% for those with stage II cancer, and 21.39% for patients with stage III carcinoma. Surgery alone was associated with significantly better overall survival than the other treatment modalities for patients with stage I disease (P = 0.029) and was associated with significantly worse overall survival for patients with stage III cancer (P < 0.001). There was no survival risk difference among the different treatment methods for patients with clinical stage II disease.Multimodality treatment is recommended for patients with stage II–III esophageal squamous-cell carcinoma. Patients with clinical stage I disease can be treated with esophagectomy without preoperative therapy.

Survival after neoadjuvant chemoradiotherapy and oesophagectomy versus definitive chemoradiotherapy for patients with oesophageal squamous cell carcinoma

“…Oesophageal cancer is the ninth most common cancer in Taiwan, with more than 90 per cent of cases being squamous cell carcinoma (SCC). Aggressive tumour biology, advanced disease stage at presentation and poor response to treatment contribute to poor survival. The National Comprehensive Cancer Network (NCCN) guidelines for oesophageal SCC recommend that patients with locally advanced disease without distant metastases are eligible for definitive chemoradiotherapy (dCRT), neoadjuvant chemoradiotherapy plus surgery (CRT‐S) or oesophagectomy alone.…”

Three Circulating LncRNA Predict Early Progress of Esophageal Squamous Cell Carcinoma

“…Esophageal carcinoma includes two main types: esophageal adenocarcinoma (EADC) and esophageal squamous cell carcinoma [4,5]. ESCC is the most common subtype with a poor treatment and survive rate with a 5-year overall survival rate about 14% [6,7]. Traditional biomarker in diagnosis ESCC mainly including CEA, CA19-9 and SCCA; However, due to the limitation of lacking sufficiently high diagnostic sensitivity or specificity, the early diagnosis of ESCC still remains poor which leading to the early metastasis before diagnosis and poor prognosis [8,9].…”

Propensity Score Analysis Comparing Survival Between Definitive Chemoradiotherapy and Esophagectomy with Adjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma

“…Esophageal squamous cell carcinoma(ESCC) is one of the leading causes of cancer-related death. Esophageal cancer is associated with poor survival outcome because of its aggressive tumor biology, diagnosis at advanced stages, and high recurrence rate [1][2][3]. ESCC has high prevalence in East Asia, with Taiwan being one of the highprevalence areas.…”