Open AccessStage selection for neoadjuvant radiotherapy in non‐cervical esophageal cancer: A propensity score‐matched study based on the SEER database
Author(s) -
Ma Ke,
Yang Yong,
Wang Shuai,
Yang Xiaodong,
Lu Tao,
Xi Junjie,
Jiang Wei,
Zhan Cheng,
Zhu Yimeng,
Wang Qun
Publication year - 2018
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12794
Subject(s) - medicine , propensity score matching , esophageal cancer , oncology , stage (stratigraphy) , radiation therapy , surveillance, epidemiology, and end results , cervical cancer , neoadjuvant therapy , esophageal neoplasm , cancer , cancer registry , breast cancer , paleontology , biology
Background The effect of neoadjuvant radiotherapy (NRT) was controversial in non‐cervical esophageal cancer. The aim of this study was to identify which stage of non‐cervical esophageal cancer would get benefit from NRT using propensity score matching (PSM) and survival analysis based on the Surveillance Epidemiology, and End Results (SEER) database. Methods A selection process was used for case screening from the SEER database. Seven baseline variables were included in PSM. The survival analysis were based on T stage (T 2 and T 3 ) and status of lymph node involvement (N 0 and N + ) using Kaplan‐Meier method and log‐rank test for comparing the overall survival of patient with NRT plus surgery versus those who with surgery alone (SA). Results A total of 1631 cases were included in this study. After PSM, 225 cases of esophageal squamous cell carcinoma (ESCC) and 606 cases of esophageal adenocarcinoma (EAC) were enrolled in survival analysis. We found that only T 3 N + stage of EAC would got survival benefit from NRT ( P = 0.0052), while NRT showed no significant benefit in overall survival in other stages of EAC and ESCC. Conclusions NRT followed by resection had a significant survival benefit in non‐cervical EAC patients with T 3 N + stage. For patients with ESCC and other EAC stages, NRT versus SA did not demonstrate a statistical significant survival difference.