Therapeutic efficacy of different adjuvant modalities in thoracic esophageal squamous cell carcinoma

Abstract

Objective To evaluation and comparison the curative effect of different adjuvant therapy and prognostic factors with thoracic esophageal squamous cell carcinoma (ESCC) after surgery, and to find the best treatment for them. Methods A total of 863 patients with thoracic ESCC underwent surgery in the fourth hospital of Hebei Medical University, From January 2007 to December 2010, To analyze the influence factors of the patient′s independent prognosis and the effect of postoperative adjuvant therapy on the prognosis of patients. The 1: 1, after the tendency of a total of 261 cases were used PSM method (87 cases/group). The Kaplan-Meier method was used to calculate OS, DFS and log-rank test and monovariable analysis, Cox model was used to multivariable analysis. Results The sample size in 1, 3, 5 was 123, 589, 863 cases. The 1-, 3-, and 5-year overall survival (OS) and disease-free survival (DFS) of all patients were 89.7%, 62.1%, 51.7% and 76.8%, 52.1%, 44.2%, respectively. The 1, 3, 5-years of OS and DFS were 956%, 73.3%, 61.1% and 85.6%, 61.1%, 54.4%, 78.9%, 38.9%, 31.3% and 67.8%, 27.8%, 20.0%, 92.2%, 55.6%, 44.4% and 67.8%, 44.4%, 36.7%(all P=0.000) among postoperation chemoradiotherapy (POCRT), postoperation chemotherapy (POCT) and postoperation radiotherapy (PORT) after pairing with PSM.The result of COX analysis showed that the degree of inflammatory adhesion, pTNM stage and the number of positive lymph nodes were the independent prognostic factors in patients with OS (P=0.002, 0.000, 0.007). The history of drinking, pTNM stage and treatment model were the independent prognostic factors of DFS (P=0.009, 0.000, 0.012). Conclusions Patients with thoracic esophageal squamous cell carcinoma after surgery to receive adjuvant therapy has a good effect, compared with PORT and POCT, POCRT can significantly improve the OS and DFS, and POCRT was the independent prognostic factors of DFS. Key words: Esophageal neoplasms/surgery; Esophageal neoplasms/radiotherapy; Esophageal neoplasms/chemotherapy; Treatment outcome; Prognosis