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Endoscopic Submucosal Dissection Followed by Chemoradiotherapy Versus Radiotherapy in Patients with Stage T1bN0M0
Yan Lin1, Cheng-Xian Ma2, Huan-Wei Liang2
1Department of Gastroenterology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530000, People's Republic of China.
Purpose:
To compare survival outcomes between endoscopic submucosal dissection (ESD) followed by chemoradiotherapy versus radiotherapy in stage T1bN0M0 esophageal cancer.
Materials And Methods:
Patients with stage T1bN0M0 esophageal cancer between 2000 and 2021 were identified from the Surveillance, Epidemiology, and End Results database. Cancer-specific survival (CSS) and overall survival (OS) were compared between the ESD followed by chemoradiotherapy versus radiotherapy cohorts.
Results:
Among 71 eligible patients, 57 (80.3%) received ESD followed by chemoradiotherapy and 14 (19.7%) underwent ESD followed by radiotherapy. Before propensity score matching, ESD followed by radiotherapy demonstrated inferior 5-year CSS (hazard ratio [HR] = 3.27, 95% confidence interval [CI] 1.12-9.58, P = 0.030), but comparable 5-year OS (HR = 1.46; 95% CI, 0.65-3.27; P = 0.362) versus ESD followed by chemoradiotherapy. After propensity score matching, no significant difference in 5-year CSS (HR = 1.76; 95% CI, 0.49-6.34; P = 0.386) or OS (HR = 1.33; 95% CI, 0.48-3.74; P = 0.585) was observed between treatment groups.
Conclusion:
ESD followed by radiotherapy provides equivalent CSS and OS compared to ESD followed by chemoradiotherapy in patients with stage T1bN0M0 esophageal cancer.
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