title: Survival benefit of surgery with radiotherapy vs surgery alone to patients with T2-3N0M0 stage esophageal adenocarcinoma.
abstract: OBJECTIVE
  This study is designed to analyze survival benefit of (neo-) adjuvant radiotherapy to patients with T2-3N0M0 stage esophageal adenocarcinoma (EAC).
  
  
  METHODS
  T2-3N0M0 stage EAC patients from 2004 to 2012 were searched from the Surveillance Epidemiology and End Results (SEER) data. Clinical factors including age, sex, race were summarized. Univariate, multivariate analysis, and stratified cox analysis based on different T stages were performed to explore the survival effect of (neo-)adjuvant radiotherapy to T2-3N0M0 stage EAC.
  
  
  RESULTS
  T2-3N0M0 stage EAC patients with surgery were more likely to be white race, T3 stage. Univariate analysis showed sex, age, and T stage were the prognostic factors of survival (P<0.05). Multivariate analysis proved (neo-)adjuvant radiotherapy can prolong survival time of T2-3N0M0 stage EAC (P<0.05). Further analysis based on different T stages showed that both neoadjuvant radiotherapy (HR 0.615; 95% CI 0.475-0.797) and adjuvant radiotherapy (HR 0.597; 95% 0.387-0.921) significantly reduced the risk of death of T3N0M0 stage EAC, but neither of which significantly reduced death risk of T2N0M0 stage EAC (P>0.05).
  
  
  CONCLUSIONS
  sex, age are the independent prognostic factors of T2-3N0M0 EAC. Significant survival benefit of (neo-)adjuvant radiotherapy is only observed in patients with T3N0M0 stage EAC, but not in those with T2N0M0 stage.
authors: Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an 223300, China.
authors: Yaqi
authors: Y
authors: Song
authors: Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an 223300, China.
authors: Guangzhou
authors: G
authors: Tao
authors: Department of Oncology, Taizhou people's hospital, Taizhou 225300, China.
authors: Qing
authors: Q
authors: Guo
authors: Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors: Xi
authors: X
authors: Yang
authors: Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors: Hongcheng
authors: H
authors: Zhu
authors: Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an 223300, China.
authors: Wanwei
authors: W
authors: Wang
authors: Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors: Xinchen
authors: X
authors: Sun
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D000368:Aged; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D018426:SEER Program / Q000706:statistics & numerical data; D016019:Survival Analysis; D014481:United States
keywords: SEER program; adenocarcinoma; esophageal cancer; radiotherapy; surgery