KEY TAKEAWAYS
- The study aimed to investigate the long-term outcomes of locally advanced TESCC with and without postoperative radiotherapy.
- Researchers noticed that postoperative radiotherapy improves survival and reduces recurrence in patients with advanced T3-4 TESCC without neoadjuvant treatment.
Ya Zeng and the team aimed to define the long-term outcomes and recurrence patterns of patients with locally advanced thoracic esophageal squamous cell carcinoma (TESCC) treated with or without postoperative radiotherapy (PORT).
They performed an inclusive analysis of a retrospective cohort from 2 academic centers, encompassing patients who initially underwent esophagectomy and were pathologically staged T3-4. Survival outcomes were constructed using the Kaplan-Meier method, and survival significance was evaluated using the log-rank test. Propensity score matching (PSM) was utilized to balance potential selection bias among patients.
About 506 patients were analyzed, with 251 undergoing surgery alone and 255 receiving radiotherapy following radical surgery. With a median follow-up of 49.1 months, PORT significantly improved 5-year overall survival (53.8% vs. 25.3%; P < 0.001) and 5-year disease-free survival rates (45.3% vs. 8.5%; P < 0.001) compared to surgery alone.
These differences in survival outcomes persisted even after PSM (P < 0.001 for both). Treatment failure was significantly less frequent in the PORT group (46.7%) compared to the surgery-only group (90.0%; P < 0.001), with corresponding reductions in locoregional recurrence (9.4% vs. 54.1%; P < 0.001). This underscores the significant association between PORT and disease control.
The study concluded that the absence of neoadjuvant chemoradiotherapy emphasizes the critical role of postoperative radiotherapy in enhancing survival and minimizing recurrence in advanced T3-4 patients with TESCC, underscoring its significance as a salvage treatment for those without prior neoadjuvant therapy.
This study was funded by the Emerging advanced technology joint research project of Shanghai Shenkang Hospital Development Center (SHDC12017103) and Shanghai Science and Technology Fund (21Y11913000).
Source: https://pubmed.ncbi.nlm.nih.gov/39334405/
Zeng Y, Su X, Zhou T, et al. (2024). “Propensity-matched study on locally advanced esophageal cancer: surgery versus post-operative radiotherapy.” Radiat Oncol. 2024;19(1):130. Published 2024 Sep 27. doi:10.1186/s13014-024-02528-0
