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Erschienen in: International Journal of Clinical Oncology 5/2016

15.03.2016 | Original Article

Comparison between surgery and definitive chemoradiotherapy for patients with resectable esophageal squamous cell carcinoma: a propensity score analysis

verfasst von: Motoo Nomura, Isao Oze, Takeshi Kodaira, Tetsuya Abe, Azusa Komori, Yukiya Narita, Toshiki Masuishi, Hiroya Taniguchi, Shigenori Kadowaki, Takashi Ura, Masashi Andoh, Hiroyuki Tachibana, Norihisa Uemura, Masahiro Tajika, Yasumasa Niwa, Manabu Muto, Kei Muro

Erschienen in: International Journal of Clinical Oncology | Ausgabe 5/2016

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Abstract

Purpose

Our intent was to compare survival following neoadjuvant chemotherapy followed by surgery versus chemoradiotherapy (CRT) among patients with potentially resectable esophageal squamous cell carcinoma.

Methods

Information about 406 consecutive esophageal cancer patients with resectable disease who underwent surgery with neoadjuvant chemotherapy consisting of cisplatin plus 5-fluorouracil or who underwent definitive CRT was reviewed. The survival outcomes were analyzed using the Kaplan–Meier method and propensity score-adjusted Cox proportional hazards models. Relevant variables were included in the propensity score model.

Results

Overall, 206 patients planned to undergo surgery (S group) and 200 patients planned to undergo CRT (CRT group). In the unadjusted situation, progression-free survival and overall survival did not differ statistically between the groups. After matching, both survival outcomes were better in the S group compared to the CRT group. Subanalysis showed both survival outcomes were better in the S group for patients with only stage III disease. However, survival outcomes for stages I, II, and IV were not significantly different between treatment groups.

Conclusions

Among patients with resectable disease, survival outcomes in the S group were favored over those of the CRT group. These results indicate that different therapeutic strategies should be used for stage III esophageal cancer than for other stages.
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Literatur
1.
Zurück zum Zitat Tachimori Y, Ozawa S, Numasaki H et al (2015) Comprehensive registry of esophageal cancer in Japan, 2008. Esophagus 12:130–157CrossRef Tachimori Y, Ozawa S, Numasaki H et al (2015) Comprehensive registry of esophageal cancer in Japan, 2008. Esophagus 12:130–157CrossRef
2.
Zurück zum Zitat Ishikura S, Nihei K, Ohtsu A et al (2003) Long-term toxicity after definitive chemoradiotherapy for squamous cell carcinoma of the thoracic esophagus. J Clin Oncol 21:2697–2702CrossRefPubMed Ishikura S, Nihei K, Ohtsu A et al (2003) Long-term toxicity after definitive chemoradiotherapy for squamous cell carcinoma of the thoracic esophagus. J Clin Oncol 21:2697–2702CrossRefPubMed
3.
Zurück zum Zitat Teoh AY, Chiu PW, Yeung WK et al (2013) Long-term survival outcomes after definitive chemoradiation versus surgery in patients with resectable squamous carcinoma of the esophagus: results from a randomized controlled trial. Ann Oncol 24:165–171CrossRefPubMed Teoh AY, Chiu PW, Yeung WK et al (2013) Long-term survival outcomes after definitive chemoradiation versus surgery in patients with resectable squamous carcinoma of the esophagus: results from a randomized controlled trial. Ann Oncol 24:165–171CrossRefPubMed
4.
Zurück zum Zitat Hironaka S, Ohtsu A, Boku N et al (2003) Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T(2–3)N(any) M(0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys 57:425–433CrossRefPubMed Hironaka S, Ohtsu A, Boku N et al (2003) Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T(2–3)N(any) M(0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys 57:425–433CrossRefPubMed
5.
Zurück zum Zitat Pöttgen C, Stuschke M (2012) Radiotherapy versus surgery within multimodality protocols for esophageal cancer–a meta-analysis of the randomized trials. Cancer Treat Rev 38:599–604CrossRefPubMed Pöttgen C, Stuschke M (2012) Radiotherapy versus surgery within multimodality protocols for esophageal cancer–a meta-analysis of the randomized trials. Cancer Treat Rev 38:599–604CrossRefPubMed
6.
Zurück zum Zitat Worni M, Martin J, Gloor B et al (2012) Does surgery improve outcomes for esophageal squamous cell carcinoma? An analysis using surveillance epidemiology and end results registry form 1998 to 2008. J Am Coll Surg 215:643–651CrossRefPubMedPubMedCentral Worni M, Martin J, Gloor B et al (2012) Does surgery improve outcomes for esophageal squamous cell carcinoma? An analysis using surveillance epidemiology and end results registry form 1998 to 2008. J Am Coll Surg 215:643–651CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Ando N, Kato H, Igaki H et al (2012) A randomized trial CF postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol 19:68–74CrossRefPubMed Ando N, Kato H, Igaki H et al (2012) A randomized trial CF postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol 19:68–74CrossRefPubMed
8.
Zurück zum Zitat Matsuda S, Tsubosa Y, Niihara M et al (2015) Comparison of transthoracic esophagectomy with definitive chemoradiotherapy as initial treatment for patients with esophageal squamous cell carcinoma who could tolerate transthoracic esophagectomy. Ann Surg Oncol 22:1866–1873CrossRefPubMed Matsuda S, Tsubosa Y, Niihara M et al (2015) Comparison of transthoracic esophagectomy with definitive chemoradiotherapy as initial treatment for patients with esophageal squamous cell carcinoma who could tolerate transthoracic esophagectomy. Ann Surg Oncol 22:1866–1873CrossRefPubMed
9.
Zurück zum Zitat International Commission of Radiation Units and Measurements (1993) ICRU Report 50: Prescribing, recording, and reporting photon beam therapy. International Commission on Radiation Units and Measurements, Bethesda International Commission of Radiation Units and Measurements (1993) ICRU Report 50: Prescribing, recording, and reporting photon beam therapy. International Commission on Radiation Units and Measurements, Bethesda
10.
Zurück zum Zitat International Commission of Radiation Units and Measurements (1999) ICRU Report 62: Prescribing, recording, and reporting photon beam therapy (supplement to ICRU Report 50). International Commission on Radiation Units and Measurements, Bethesda International Commission of Radiation Units and Measurements (1999) ICRU Report 62: Prescribing, recording, and reporting photon beam therapy (supplement to ICRU Report 50). International Commission on Radiation Units and Measurements, Bethesda
11.
Zurück zum Zitat Ohtsu A, Boku N, Muro K et al (1999) Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol 17:2915–2921PubMed Ohtsu A, Boku N, Muro K et al (1999) Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol 17:2915–2921PubMed
12.
Zurück zum Zitat Kato H, Sato A, Fukuda H et al (2009) A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol 39:638–643CrossRefPubMed Kato H, Sato A, Fukuda H et al (2009) A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol 39:638–643CrossRefPubMed
13.
Zurück zum Zitat Kodaira T, Fuwa N, Kamata M et al (2006) Single-institute phase I/II trial of alternating chemoradiotherapy with 5-FU and nedaplatin for esophageal carcinoma. Anticancer Res 26:471–478PubMed Kodaira T, Fuwa N, Kamata M et al (2006) Single-institute phase I/II trial of alternating chemoradiotherapy with 5-FU and nedaplatin for esophageal carcinoma. Anticancer Res 26:471–478PubMed
14.
Zurück zum Zitat Sumi H, Ohtsu A, Boku N et al (2000) A case of inoperable esophageal carcinoma with hepatic and nodal metastases which showed a long-term survival after chemoradiotherapy including nedaplatin. Jpn J Clin Oncol 30:406–409CrossRefPubMed Sumi H, Ohtsu A, Boku N et al (2000) A case of inoperable esophageal carcinoma with hepatic and nodal metastases which showed a long-term survival after chemoradiotherapy including nedaplatin. Jpn J Clin Oncol 30:406–409CrossRefPubMed
15.
Zurück zum Zitat Minsky BD, Pajak TF, Ginsberg RJ et al (2002) INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 20:1167–1174CrossRefPubMed Minsky BD, Pajak TF, Ginsberg RJ et al (2002) INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 20:1167–1174CrossRefPubMed
16.
Zurück zum Zitat van Hagen P, Hulshof MC, van Lanschot JJ et al (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084CrossRefPubMed van Hagen P, Hulshof MC, van Lanschot JJ et al (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084CrossRefPubMed
17.
Zurück zum Zitat Urschel JD, Vasan H (2003) A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer. Am J Surg 185:538–543CrossRefPubMed Urschel JD, Vasan H (2003) A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer. Am J Surg 185:538–543CrossRefPubMed
18.
Zurück zum Zitat Herskovic A, Martz K, Al-Sarraf M et al (1992) Combined chemotherapy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus. N Engl J Med 326:1593–1598CrossRefPubMed Herskovic A, Martz K, Al-Sarraf M et al (1992) Combined chemotherapy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus. N Engl J Med 326:1593–1598CrossRefPubMed
19.
Zurück zum Zitat Stahl M, Walz MK, Stuschke M et al (2009) Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol 27:851–856CrossRefPubMed Stahl M, Walz MK, Stuschke M et al (2009) Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol 27:851–856CrossRefPubMed
20.
Zurück zum Zitat Siewert JR, Ott K (2007) Are squamous and adenocarcinomas of the esophagus the same disease? Semin Radiat Oncol 17:38–44CrossRefPubMed Siewert JR, Ott K (2007) Are squamous and adenocarcinomas of the esophagus the same disease? Semin Radiat Oncol 17:38–44CrossRefPubMed
21.
Zurück zum Zitat Rice TW, Rusch VW, Apperson-Hansen C et al (2009) Worldwide esophageal cancer collaboration. Dis Esophagus 22:1–8 Rice TW, Rusch VW, Apperson-Hansen C et al (2009) Worldwide esophageal cancer collaboration. Dis Esophagus 22:1–8
22.
Zurück zum Zitat Bedenne L, Michel P, Bouché O et al (2007) Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol 25:1160–1168CrossRefPubMed Bedenne L, Michel P, Bouché O et al (2007) Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol 25:1160–1168CrossRefPubMed
Metadaten
Titel
Comparison between surgery and definitive chemoradiotherapy for patients with resectable esophageal squamous cell carcinoma: a propensity score analysis
verfasst von
Motoo Nomura
Isao Oze
Takeshi Kodaira
Tetsuya Abe
Azusa Komori
Yukiya Narita
Toshiki Masuishi
Hiroya Taniguchi
Shigenori Kadowaki
Takashi Ura
Masashi Andoh
Hiroyuki Tachibana
Norihisa Uemura
Masahiro Tajika
Yasumasa Niwa
Manabu Muto
Kei Muro
Publikationsdatum
15.03.2016
Verlag
Springer Japan
Erschienen in
International Journal of Clinical Oncology / Ausgabe 5/2016
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-016-0963-3

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