Abstract
The treatment for locally advanced esophageal cancer remains unclear. We compared the clinical outcomes between neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery and definitive CCRT in patients with clinical stage III esophageal cancer from Asians population using a national cancer registry database. Eligible patients diagnosed from 2010 to 2015 were collected from the Taiwan Cancer Registry. To balance observable potential confounders, we constructed a 1:1 propensity score-matched cohort (surgery: CCRT = 1:1). We compared the overall survival for 5 years. Our study population included 1988 patients, 944 in the surgery group and 944 in the CCRT group. The histological type of the patients contained 97.2% squamous cell carcinoma and 1.6% adenocarcinoma. The 3-year-survival rate between surgery and CCRT group was 43% and 19%, respectively. The 5-year-survival rate between surgery and CCRT group were 33% and 13%, respectively (P value <0.0001). The hazard ratio of mortality was 0.452 [95% confidence interval 0.405∼0.505] when surgery was compared to CCRT. Based on the analysis of the database, neoadjuvant CCRT followed by surgery was associated with improved overall survival for stage III esophageal cancer compared to definitive CCRT.
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