674P - Prognosis impact of postoperative radiation in patients with radical esophagectomy and pathologic lymph nodes positive esophageal cancer

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Oesophageal Cancer
Pathology/Molecular Biology
Surgery and/or Radiotherapy of Cancer
Presenter Yaping Xu
Authors Y. Xu1, W. Mao1, X.J. Sun1, Y.D. Zheng1, Y. Jiang2, J. Liu2
  • 1Department Of Radiation Oncology, Zhejiang Cancer Hospital, 310022 - Hangzhou/CN
  • 2Department Of Surgery, Zhejiang Cancer Hospital, 310022 - Hangzhou/CN

Abstract

Purpose

Though postoperative radiation for esophageal cancer is offered in selected cases, there is conflicting evidence as to whether it improves overall survival (OS). We performed a retrospective investigation to analyze the prognosis impact of adjuvant radiation in a large cohort of patients.

Methods and materials

From 2002 to 2008, 545 patients underwent radical esophagectomy (R0) with or without postoperative radiation were eligible for retrospectively analysis. Patients were grouped to surgery only (n = 346) and surgery plus postoperative radiation therapy (PORT) (n = 199). Radiation dose was 50 Gy in 25 fractions. Kaplan-Meier and Cox regression analysis were used to compare OS.

Results

The use of PORT was associated with significantly improved OS (p =0.006). The median OS was 31 months in the group receiving PORT and 21 months in the group undergoing surgery alone. The addition of PORT improved OS at 3 years from 38.3 to 45.8% compared with surgery alone. For American Joint Committee on Cancer (AJCC) stage III esophageal cancer (T1-2N2M0, T3N1-2M0, T4N1-3M0), there was significant improvement on OS (p < 0.001) in PORT group, for not only metastatic lymph-node ratio <0.25 (p = 0.047), but also metastatic lymph-node ratio >0.25 (p = 0.013). However, for stages IIB disease (T1-2N1M0) there was no significant differences.

Conclusions

This large population-based analysis supports the use of PORT for pathologic lymph nodes positive stage III esophageal cancer. Our results suggest that a subset of such patients may benefit from aggressive local therapy. As a retrospective study, our results do not have the same strength as a prospective study, however, it provides a basis for the design of future randomized, prospective clinical trials.

Disclosure

All authors have declared no conflicts of interest.