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Erschienen in: Journal of Cancer Research and Clinical Oncology 1/2016

01.01.2016 | Original Article – Clinical Oncology

The impact of adjuvant radiotherapy on radically resected T3 esophageal squamous cell carcinoma

verfasst von: Shao-bin Chen, Hong-rui Weng, Geng Wang, Di-tian Liu, Hua Li, Hao Zhang, Yu-ping Chen

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 1/2016

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Abstract

Purpose

The role of adjuvant radiotherapy in patients with esophageal squamous cell carcinoma (ESCC) remains controversial. This retrospective study was designed to analyze the impact of adjuvant radiotherapy in patients with T3 stage ESCC after radical resection.

Methods

Data of a single-center cohort of 692 patients with T3 stage ESCC who underwent radical resection, with or without adjuvant radiotherapy, were reviewed. Univariate and multivariate analyses were performed to compare overall survival (OS) and locoregional recurrence-free survival (LRFS).

Results

Two hundred and forty-six patients received adjuvant radiotherapy (S + R group), and 446 patients underwent surgery alone (S group). The median survival time and 5-year OS rate were 40.0 months and 40.9 % for the entire population, 50.0 months and 45.6 % for the S + R group and 38.0 months and 38.3 % for the S group (P = 0.114 for S + R group vs. S group). The 5-year LRFS rate for the S + R group was significantly higher than that for S group (50.8 vs. 35.9 %, P < 0.001). In subgroup analyses, adjuvant radiotherapy was found to improve the 5-year OS in the subgroups of tumor length >5 cm, pN0 and pN1 categories, pTNM stage IIa, IIb and IIIa (P < 0.005).

Conclusions

Adjuvant radiotherapy is effective in local control of radically resected T3 stage ESCC and may improve the overall survival in certain subgroups, such as the patients with tumor length >5 cm, pN0 and pN1 categories, pTNM stage IIa, IIb and IIIa. Further studies are required to confirm our results.
Literatur
Zurück zum Zitat Chen J, Pan J, Zheng X, Zhu K, Li J, Chen M, Wang J, Liao Z (2012) Number and location of positive nodes, postoperative radiotherapy, and survival after esophagectomy with three-field lymph node dissection for thoracic esophageal squamous cell carcinoma. Int J Radiat Oncol Biol Phys 82:475–482. doi:10.1016/j.ijrobp.2010.08.037 PubMedCrossRef Chen J, Pan J, Zheng X, Zhu K, Li J, Chen M, Wang J, Liao Z (2012) Number and location of positive nodes, postoperative radiotherapy, and survival after esophagectomy with three-field lymph node dissection for thoracic esophageal squamous cell carcinoma. Int J Radiat Oncol Biol Phys 82:475–482. doi:10.​1016/​j.​ijrobp.​2010.​08.​037 PubMedCrossRef
Zurück zum Zitat Chen J, Pan J, Liu J, Li J, Zhu K, Zheng X, Chen M, Chen M, Liao Z (2013) Postoperative radiation therapy with or without concurrent chemotherapy for node-positive thoracic esophageal squamous cell carcinoma. Int J Radiat Oncol Biol Phys 86:671–677. doi:10.1016/j.ijrobp.2013.03.026 PubMedCrossRef Chen J, Pan J, Liu J, Li J, Zhu K, Zheng X, Chen M, Chen M, Liao Z (2013) Postoperative radiation therapy with or without concurrent chemotherapy for node-positive thoracic esophageal squamous cell carcinoma. Int J Radiat Oncol Biol Phys 86:671–677. doi:10.​1016/​j.​ijrobp.​2013.​03.​026 PubMedCrossRef
Zurück zum Zitat Cooper JS, Guo MD, Herskovic A, Macdonald JS, Martenson JA Jr, Al-Sarraf M, Byhardt R, Russell AH, Beitler JJ, Spencer S, Asbell SO, Graham MV, Leichman LL (1999) Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA 281:1623–1627PubMedCrossRef Cooper JS, Guo MD, Herskovic A, Macdonald JS, Martenson JA Jr, Al-Sarraf M, Byhardt R, Russell AH, Beitler JJ, Spencer S, Asbell SO, Graham MV, Leichman LL (1999) Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA 281:1623–1627PubMedCrossRef
Zurück zum Zitat Fok M, Sham JS, Choy D, Cheng SW, Wong J (1993) Postoperative radiotherapy for carcinoma of the esophagus: a prospective, randomized controlled study. Surgery 113:138–147PubMed Fok M, Sham JS, Choy D, Cheng SW, Wong J (1993) Postoperative radiotherapy for carcinoma of the esophagus: a prospective, randomized controlled study. Surgery 113:138–147PubMed
Zurück zum Zitat Fujita H, Sueyoshi S, Tanaka T, Shirouzu K (2002) Three-field dissection for squamous cell carcinoma in the thoracic esophagus. Ann Thorac Cardiovasc Surg 8:328–335PubMed Fujita H, Sueyoshi S, Tanaka T, Shirouzu K (2002) Three-field dissection for squamous cell carcinoma in the thoracic esophagus. Ann Thorac Cardiovasc Surg 8:328–335PubMed
Zurück zum Zitat Huang W, Li B, Gong H, Yu J, Sun H, Zhou T, Zhang Z, Liu X (2010) Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma: a report of 1077 cases. Radiother Oncol 95:229–233. doi:10.1016/j.radonc.2010.01.006 PubMedCrossRef Huang W, Li B, Gong H, Yu J, Sun H, Zhou T, Zhang Z, Liu X (2010) Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma: a report of 1077 cases. Radiother Oncol 95:229–233. doi:10.​1016/​j.​radonc.​2010.​01.​006 PubMedCrossRef
Zurück zum Zitat Law S, Arcilla C, Chu KM, Wong J (1998) The significance of histologically infiltrated resection margin after esophagectomy for esophageal cancer. Am J Surg 176:286–290PubMedCrossRef Law S, Arcilla C, Chu KM, Wong J (1998) The significance of histologically infiltrated resection margin after esophagectomy for esophageal cancer. Am J Surg 176:286–290PubMedCrossRef
Zurück zum Zitat Malthaner RA, Wong RK, Rumble RB, Zuraw L, Members of the Gastrointestinal Cancer Disease Site Group of Cancer Care Ontario’s Program in Evidence-based Care (2004) Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis. BMC Med 2:35. doi:10.1186/1471-2407-4-67 PubMedPubMedCentralCrossRef Malthaner RA, Wong RK, Rumble RB, Zuraw L, Members of the Gastrointestinal Cancer Disease Site Group of Cancer Care Ontario’s Program in Evidence-based Care (2004) Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis. BMC Med 2:35. doi:10.​1186/​1471-2407-4-67 PubMedPubMedCentralCrossRef
Zurück zum Zitat Shridhar R, Weber J, Hoffe SE, Almhanna K, Karl R, Meredith K (2013) Adjuvant radiation therapy and lymphadenectomy in esophageal cancer: a SEER database analysis. J Gastrointest Surg 17:1339–1345. doi:10.1007/s11605-013-2192-7 PubMedCrossRef Shridhar R, Weber J, Hoffe SE, Almhanna K, Karl R, Meredith K (2013) Adjuvant radiation therapy and lymphadenectomy in esophageal cancer: a SEER database analysis. J Gastrointest Surg 17:1339–1345. doi:10.​1007/​s11605-013-2192-7 PubMedCrossRef
Zurück zum Zitat Tam PC, Siu KF, Cheung HC, Ma L, Wong J (1987) Local recurrences after subtotal esophagectomy for squamous cell carcinoma. Ann Surg 205:189–194PubMedPubMedCentralCrossRef Tam PC, Siu KF, Cheung HC, Ma L, Wong J (1987) Local recurrences after subtotal esophagectomy for squamous cell carcinoma. Ann Surg 205:189–194PubMedPubMedCentralCrossRef
Zurück zum Zitat Ténière P, Hay JM, Fingerhut A, Fagniez PL (1991) Postoperative radiation therapy does not increase survival after curative resection for squamous cell carcinoma of the middle and lower esophagus as shown by a multicenter controlled trial. French University Association for Surgical Research. Surg Gynecol Obstet 173:123–130PubMed Ténière P, Hay JM, Fingerhut A, Fagniez PL (1991) Postoperative radiation therapy does not increase survival after curative resection for squamous cell carcinoma of the middle and lower esophagus as shown by a multicenter controlled trial. French University Association for Surgical Research. Surg Gynecol Obstet 173:123–130PubMed
Zurück zum Zitat van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, Cuesta MA, Blaisse RJ, Busch OR, ten Kate FJ, Creemers GJ, Punt CJ, Plukker JT, Verheul HM, Spillenaar Bilgen EJ, van Dekken H, van der Sangen MJ, Rozema T, Biermann K, Beukema JC, Piet AH, van Rij CM, Reinders JG, Tilanus HW, van der Gaast A, CROSS Group (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084. doi:10.1056/NEJMoa1112088 PubMedCrossRef van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, Cuesta MA, Blaisse RJ, Busch OR, ten Kate FJ, Creemers GJ, Punt CJ, Plukker JT, Verheul HM, Spillenaar Bilgen EJ, van Dekken H, van der Sangen MJ, Rozema T, Biermann K, Beukema JC, Piet AH, van Rij CM, Reinders JG, Tilanus HW, van der Gaast A, CROSS Group (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084. doi:10.​1056/​NEJMoa1112088 PubMedCrossRef
Zurück zum Zitat Veeramachaneni NK, Zoole JB, Decker PA, Putnam JB Jr, Meyers BF, American College of Surgeons Oncology Group Z0060 Trial (2008) Lymph node analysis in esophageal resection: American College of Surgeons Oncology Group Z0060 trial. Ann Thorac Surg 86:418–421. doi:10.1016/j.athoracsur.2008.04.043 PubMedCrossRef Veeramachaneni NK, Zoole JB, Decker PA, Putnam JB Jr, Meyers BF, American College of Surgeons Oncology Group Z0060 Trial (2008) Lymph node analysis in esophageal resection: American College of Surgeons Oncology Group Z0060 trial. Ann Thorac Surg 86:418–421. doi:10.​1016/​j.​athoracsur.​2008.​04.​043 PubMedCrossRef
Zurück zum Zitat Xiao ZF, Yang ZY, Liang J, Miao YJ, Wang M, Yin WB, Gu XZ, Zhang DC, Zhang RG, Wang LJ (2003) Value of radiotherapy after radical surgery for esophageal carcinoma: a report of 495 patients. Ann Thorac Surg 75:331–336PubMedCrossRef Xiao ZF, Yang ZY, Liang J, Miao YJ, Wang M, Yin WB, Gu XZ, Zhang DC, Zhang RG, Wang LJ (2003) Value of radiotherapy after radical surgery for esophageal carcinoma: a report of 495 patients. Ann Thorac Surg 75:331–336PubMedCrossRef
Zurück zum Zitat Xiao ZF, Yang ZY, Miao YJ, Wang LH, Yin WB, Gu XZ, Zhang DC, Sun KL, Chen GY, He J (2005) Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: report of 549 cases. Int J Radiat Oncol Biol Phys 62:82–90. doi:10.1016/j.ijrobp.2004.08.046 PubMedCrossRef Xiao ZF, Yang ZY, Miao YJ, Wang LH, Yin WB, Gu XZ, Zhang DC, Sun KL, Chen GY, He J (2005) Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: report of 549 cases. Int J Radiat Oncol Biol Phys 62:82–90. doi:10.​1016/​j.​ijrobp.​2004.​08.​046 PubMedCrossRef
Zurück zum Zitat Yamamoto M, Yamashita T, Matsubara T, Kitahara T, Sekiguchi K, Furukawa M, Uki A, Kobayashi M, Tanaka E, Ueda M, Nakajima T (1997) Reevaluation of postoperative radiotherapy for thoracic esophageal carcinoma. Int J Radiat Oncol Biol Phys 37:75–78. doi:10.1016/S0360-3016(96)00473-7 PubMedCrossRef Yamamoto M, Yamashita T, Matsubara T, Kitahara T, Sekiguchi K, Furukawa M, Uki A, Kobayashi M, Tanaka E, Ueda M, Nakajima T (1997) Reevaluation of postoperative radiotherapy for thoracic esophageal carcinoma. Int J Radiat Oncol Biol Phys 37:75–78. doi:10.​1016/​S0360-3016(96)00473-7 PubMedCrossRef
Zurück zum Zitat Zieren HU, Müller JM, Jacobi CA, Pichlmaier H, Müller RP, Staar S (1995) Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: a prospective randomized study. World J Surg 19:444–449. doi:10.1007/BF00299187 PubMedCrossRef Zieren HU, Müller JM, Jacobi CA, Pichlmaier H, Müller RP, Staar S (1995) Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: a prospective randomized study. World J Surg 19:444–449. doi:10.​1007/​BF00299187 PubMedCrossRef
Metadaten
Titel
The impact of adjuvant radiotherapy on radically resected T3 esophageal squamous cell carcinoma
verfasst von
Shao-bin Chen
Hong-rui Weng
Geng Wang
Di-tian Liu
Hua Li
Hao Zhang
Yu-ping Chen
Publikationsdatum
01.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 1/2016
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-015-2041-z

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