633P - Comparison of surgery with definitive chemoradiotherapy for potentially resectable esophageal cancer: A propensity-score analysis

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer agents
Oesophageal Cancer
Surgical Oncology
Therapy
Biological Therapy
Radiation Oncology
Presenter Motoo Nomura
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors M. Nomura1, T. Abe2, T. Kodaira3, I. Oze4, A. Komori1, Y. Narita1, T. Masuishi1, H. Taniguchi1, S. Kadowaki1, D. Takahari1, T. Ura1, M. Andoh1, R. Kawai2, N. Uemura2, N. Tomita3, H. Tachibana3, T. Tanaka5, M. Tajika5, Y. Niwa6, K. Muro1
  • 1Clinical Oncology, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 2Gastrointestinal Surgery, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 3Radiation Oncology, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 4Division Of Epidemiology And Prevention, Aichi Cancer Center Research Institute, Nagoya/JP
  • 5Endoscopy, Aichi Cancer Center Hospital, 4648681 - Nagoya/JP
  • 6Endoscopy, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP

Abstract

Aim

To compare the survival by surgery (S group) to that by definitive chemoradiotherapy (CRT: R group) among patients with potentially resectable esophageal squamous cell carcinoma.

Methods

From January 2003 to June 2012, 564 consecutive patients were reviewed. Overall survival (OS) was analyzed using Kaplan-Meier method and propensity-score adjusted Cox proportional hazard models. The variables included in propensity score model were age, gender, performance status (PS), histologic grade, primary cancer site, cT, cN, cM, serum albumin, and year of treatment (3 groups).

Results

Three hundreds forty-two patients was in S group and 222 patients was in R group. Of the S group, 243 had preoperative chemotherapy, 37 had postoperative chemotherapy, and 62 had no adjuvant therapy. All values in patient characteristics were significantly different between S and R groups except for gender (age ≥ 65 years, 42% vs. 58%; gender male, 85% vs. 88%; Cancer site Ut/Mt/Lt, 14/49/37% vs. 14/60/27%; PS 0/1, 28/72% vs. 37/63%; cT stage 1/2/3, 19/13/68% vs. 40/9/51%; cN stage 0/1/2/3, 22/57/21/0% vs. 36/41/22/1%; cStage 1/2/3/4, 10/29/51/9% vs. 27/23/36/14%). In both unadjusted and adjusted analysis, there were no significant differences in survival of patients with cT1 and cT2 stages individually between S and R groups (cT1, unadjusted hazard radio (uHR) 1.9, p = 0.15; adjusted hazard radio (aHR) 1.5, p = 0.38. cT2, uHR2.1, p = 0.20; aHR1.8, p = 0.39). The R group was associated with worse OS compared to S group in those with cT3 stage (uHR1.9, p = 0.001; aHR1.8, p = 0.003). While OS benefit of S group was detected for cStage III patients (uHR2.2, p < 0.001; aHR2.1, p = 0.002), there were no significant differences in survival of those with cStage I or II between 2 groups (cStage I, uHR2.3, p = 0.15; aHR1.9, p = 0.34. cStage II, uHR1.0, p = 0.96; aHR1.1, p = 0.87). Although patients with cStage IV in S group showed significantly better OS in unadjusted analysis, this survival benefit was not present after adjustment as well (cStage IV, uHR3.3 p = 0.019; aHR2.8, p = 0.08).

Conclusions

Our study indicated CRT is comparable survival to surgery based therapy for patients with esophageal squamous cell carcinoma except for patients with cT3 or cStage III.

Disclosure

All authors have declared no conflicts of interest.