• Shan Huang, Yuxing Li, Hongbing Ma, Wenyu Wang, Shuyu Zheng, Yue Ke, and Fang Li.
• Department of Radiation Oncology, Second Affiliated Hospital, Xi'an Jiaotong University, No.157, Xi Wu Road, Xi'an, 710004, Shaanxi, China. huangshan2016@xjtu.edu.cn.
• J. Gastrointest. Surg. 2019 Nov 1; 23 (11): 2111-2118.

PurposeTo evaluate the survival benefit of combining radiotherapy with surgery in locally advanced esophageal squamous cell carcinoma (ESCC) patients aged over 65.MethodsUsing the SEER database, we selected patients age ≥ 65 years that were diagnosed as locally advanced ESCC during 2004-2013. Cancer-specific survival (CSS) was examined using the Kaplan-Meier analysis and compared by the log-rank test. Univariable and multivariable Cox proportional hazard models were established to identify possible prognostic factors.ResultsA total of 972 cases were included in the study. For surgical patients aged 65-79 years, 74 patients (32.9%) were treated by surgery alone and 122 patients (54.2%) had received additional neoadjuvant radiotherapy (NRT). NRT + surgery was associated with improved CSS comparing with surgery alone (HR, 0.58; 95%CI, 0.39 to 0.85; P = 0.005). In subgroup analysis, NRT was associated with improved CSS for patients aged 65-74 years (2-year CSS 56.6% versus 39.6%, P = 0.026). No significant differences of progonosis was observed for different treatment groups in 75-79 years patients (P = 0.972).ConclusionsIn this SEER-based study, the addition of neoadjuvant radiotherapy before surgery was associated with improved CSS for locally advanced ESCC patients aged 65 to 74 years.

26 keywords...

hide…