The impact of adjuvant therapy on survival for node-negative esophageal squamous cell carcinoma: a propensity score- matched analysis

Abstract

Background: At present, the primary treatment of esophageal cancer is surgery-based comprehensive treatment, including adjuvant therapy such as chemotherapy and/or radiotherapy. However, the role of adjuvant therapy for esophageal squamous cell carcinoma (ESCC) with pathologically node-negative (pN0) disease is controversial. This study aimed to evaluate the impact of postoperative adjuvant therapy on survival in patients with pN0 ESCC.Methods: Patients with ESCC who underwent R0 esophagectomy in the Department of Thoracic Surgery of Sichuan Cancer Hospital from January 2008 to December 2013 were enrolled. Patients were divided into two groups: a surgery alone (Group S) group or a surgery + adjuvant therapy (Group S + A) group. The primary outcomes were overall survival (OS) and disease-free survival (DFS), and every consecutive case was followed up until death or the last follow-up.Results: A total of 387 patients with ESCC patients who had pN0 were enrolled in the study. After propensity score matching (PSM), each group consisted of 150 patients. In the overall cohort, the 5-year OS (75.6% vs. 69.7%; P=0.004) and 5-year DFS (64.9% vs. 48.2%; P=0.003) rates were higher in Group S + A than in Group S. In the matched samples, the same outcomes were observed (5-year OS: 75.6% vs.

Effect of postoperative adjuvant chemotherapy on esophageal squamous cell carcinoma patients with lymphovascular invasion and without lymph node metastasis

“…Other studies showed that ESCC patients with LVI were more likely to have LNM, and LVI strongly correlated with reduced RFS [20][21][22]. In the present study, the 5-year OS rate was 40.9% and 41.6% in the AC and NC groups, respectively, which were lower than the 5-year OS rate of lymph node-negative (pN0) ESCC patients (75.6% vs 69.7% in the postoperative treatment and surgery alone groups, respectively) [23]. Bone metastasis and local LNM were the most common recurrence patterns, which are consistent with ndings from previous studies [24].…”

Optimal extent of lymphadenectomy improves prognosis and guides adjuvant chemotherapy in esophageal cancer: A propensity score-matched analysis

“…Adjuvant chemotherapy may do more harm than good to patients in this population. On the contrary, Deng et al [ 28 ] showed that adjuvant chemotherapy prolonged OS and DFS in ESCC patients with pN0 disease. Further research is needed to elucidate such differences.…”

Development and validation of a prognostic nomogram for predicting cancer-specific survival in lymph node-negative elderly esophageal cancer patients: A SEER-based study

“…In previous studies, tumor size was not an independent prognostic factor in patients with node-negative EC. [6,8,9,[19][20][21][22] However, to our knowledge, tumor size is closely related to the choice of treatment options. In our data, for patients with a tumor size >59 mm, only 20.4% (153/620) of the patients underwent surgery, however, when the tumor size was <22 mm, 69.2% (666/962) of the patients underwent the surgery, which would result in a completely different patient prognosis.…”

“…The relationship between adjuvant therapy and the prognosis of node-negative EC patients has been explored in numerous studies, but the conclusions remain uncertain. [6][7][8][9][10] Furthermore, prognostic factors such as age, sex, and tumor size should be considered when evaluating these patients. Therefore, we aim to achieve a more accurate prognosis analysis by analyzing information on demographic characteristics, clinicopathological characteristics, and treatment methods in the surveillance, epidemiology, and end results Program (SEER) databases.…”