title: Comparison of pathologic stage in patients receiving esophagectomy with and without preoperative chemoradiation therapy for esophageal SCC.
abstract: The prognostic value for the post-chemoradiation therapy (CRT) pathologic stage is uncertain. The purpose of this study was to compare the pathologic stage in patients undergoing esophagectomy with and without preoperative CRT for esophageal squamous cell carcinoma (ESCC). This study retrospectively reviewed the data from 2151 patients with ESCC who underwent esophagectomy with or without preoperative CRT between 2008 and 2011 in Taiwan. Patients were divided into 2 groups. Group A consisted of patients treated with primary surgery without prior treatments (n=1301), and group B consisted of patients receiving preoperative CRT followed by esophagectomy (n=850). In group A, 679 patients received surgery alone, 92 received postoperative chemotherapy, 416 received postoperative chemoradiation therapy, and 114 received postoperative radiation therapy. In group A, the 3-year survival rates by pathologic stage were 82.2% for stage 0, 67.6% for stage I, 50.7% for stage II, 21.5% for stage III, and 14.8% for stage IV (P<.001). In group B, the 3-year survival rates of post-CRT pathologic stages 0, I, II, III, and IV were 59.4%, 46.0%, 40.3%, 19.1%, and 8.2%, respectively (P<.001). In multivariate analysis, the pathologic T, N, and M were all independent prognostic factors in both group A (esophagectomy alone) and B (CRT plus esophagectomy). The current, 7th edition of the esophageal TNM staging system could adequately stratify prognostic groups in patients with squamous cell carcinoma who were treated with preoperative CRT and esophagectomy.
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centr
authors.forename: Bing-Yen
authors.initials: BY
authors.lastname: Wang
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ping-Yi
authors.initials: PY
authors.lastname: Lin
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shiao-Chi
authors.initials: SC
authors.lastname: Wu
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hui-Shan
authors.initials: HS
authors.lastname: Chen
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Hsu
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chih-Shiun
authors.initials: CS
authors.lastname: Shih
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centr
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Liu
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chia-Chuan
authors.initials: CC
authors.lastname: Liu
authors.affiliation: From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. From the Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan; Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D013624:Taiwan