pT3N0M0期胸段食管鳞癌术后辅助性治疗对预后影响的初步分析

doi:10.3760/cma.j.issn.1004-4221.2017.08.005

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Abstract Objective To determine the prognostic factors in patients with stage pT₃N₀M₀ thoracic esophageal squamous cell carcinoma (TSCC) after esophagectomy, and to compare the effects of different treatment modalities on the prognosis of patients. Methods A retrospective analysis was conducted on 480 patients with stage pT₃N₀M₀ TSCC from 2007 to 2010 to determine the prognostic factors in the patients, and to compare the effects of different treatment modalities on their prognosis. Survival rate was calculated using the Kaplan-Meier estimator, and multivariate analysis of prognostic factors was performed using the Cox model. Results Of the 439, 333, and 278 patients who completed the 1-, 3-, and 5-year follow-up, respectively, the 1-, 3-, and 5-year overall survival (OS) rates were 90.0%, 68.7%, and 57.9%(median 87 months, 95% confidence interval (CI=74.7-99.4), respectively, and the 1-, 3-, and 5-year disease-free survival (DFS) rates were 82.3%, 60.4%, and 52.3%(median 71.3 months, 95%CI=55.1-87.5), respectively. In order to account for the different constituent ratios of some clinical and pathological data between the three groups of patients, 55 patients in each group were matched using propensity score matching (PSM)(all P>0.05). It was found that the post-PSM 1-,3-, and 5-year OS and DFS were significantly different between patients who received surgery only, postoperative chemotherapy (POCT), and postoperative chemoradiotherapy/radiotherapy (POCRT/RT)(P=0.000 and 0.006,respectively). Multivariate Cox analysis showed that age, lesion location, and treatment modality were independent prognostic factors for OS and DFS (P=0.029,0.004,0.000 and P=0.009,0.003,0.002), and the length of lesion was also an independent prognostic factor for DFS (P=0.003). Conclusions Although the rate of post-operative treatment failure is still high among patients with stage pT₃N₀M₀ TSCC, POCRT/PORT can improve the prognosis and the 5-year OS and DFS of these patients. However, further large-sample prospective studies will be required to confirm these findings.

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	Articles by authors
	Shen Wenbin
	Gao Hongmei
	Zhu Shuchai
	Li Teng
	Li Shuguang
	Li Youmei
	Liu Zhikun
	Li Juan
	Su Jingwei

Key words： Esophageal neoplasms/surgery Esophageal neoplasms/postoperative radiotherapy Esophageal neoplasms/postoperative chemotherapy Prognosis

Received: 14 November 2016

Corresponding Authors: Zhu Shuchai,Email:sczhu1965@163.com

Cite this article:

Shen Wenbin,Gao Hongmei,Zhu Shuchai et al. Effect of postoperative adjuvant therapy on the prognosis of patients with stage pT₃N₀M₀ thoracic esophageal squamous cell carcinoma:a preliminary analysis[J]. Chinese Journal of Radiation Oncology, 2017, 26(8): 867-873.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.08.005 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I8/867

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